General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal

Area of Science:

• Gerontology
• Pharmacology
• Public Health

Background:

• Osteoporosis diagnosis and antiosteoporosis medication use have risen significantly in recent decades.
• Despite increased awareness, osteoporosis management remains suboptimal worldwide, with less than 20% of patients receiving appropriate therapy post-fracture.
• Treatment rates for osteoporosis have notably declined globally in the last 5-10 years.

Purpose of the Study:

• To investigate the reasons behind the observed decline in osteoporosis treatment rates.
• To identify strategies for improving osteoporosis care and reducing fracture incidence.

Main Methods:

• Review of current literature on osteoporosis care trends.
• Analysis of factors contributing to suboptimal treatment and declining rates.
• Examination of potential interventions for enhancing secondary and primary prevention.

Main Results:

• Identified contributing factors include low prioritization in aging, multimorbid populations, and concerns over rare side effects of anti-resorptive medications.
• Adverse changes in reimbursement policies in the USA have also impacted treatment rates.
• Evidence suggests a substantial decline in treatment initiation following fragility fractures in many countries.

Conclusions:

• Addressing the decline in osteoporosis care requires a multi-faceted approach.
• Improved secondary prevention, enhanced screening, and optimized cost-effective guidelines are crucial for better osteoporosis management.
• Implementing these strategies can help optimize care and prevent future fractures.