[Structured care of patients with osteoporosis in Germany : Disease Management Program and Fracture Liaison Service]

Osteoporosis is a chronic skeletal disease affecting more than 200 mil. people worldwide. The care approach is based on three levels of prevention: primary prevention to promote bone health, secondary prevention for early detection and treatment, and tertiary prevention to avoid subsequent fractures and maintain quality of life.

In 2020, the Osteoporosis Disease Management Program (DMP) was approved by the Federal Joint Committee (G-BA). It aims to provide structured, guideline-based care for patients with manifest or impending osteoporosis. Key components include defined inclusion criteria, regular diagnostics (e.g., DXA, laboratory testing), standardized pharmacologic therapy (including bisphosphonates, denosumab, SERMs, teriparatide), patient education, fall prevention, and quality-assured follow-up.

The Fracture Liaison Service (FLS) is a multidisciplinary model for post-fracture care in patients with fragility fractures. It addresses the care gap between acute fracture treatment and tertiary prevention. By systematically identifying patients, assessing risk, initiating individualized therapy, and providing structured follow-up, FLS demonstrably improves adherence, reduces refracture rates, and lowers mortality.

DMP and FLS represent complementary, evidence-based care models that together hold significant potential to improve osteoporosis management in Germany.