Medicus, Vol. 31 No. 2 Osteoporoza, 2022.
Review article
Missed Opportunities in Treating Osteoporosis: What Can We Do for the Secondary Prevention of Osteoporotic Fractures?
Simeon Grazio
Jelena Marunica Karšaj
Abstract
This paper outlines the issue of secondary prevention of osteoporotic fractures, especially in the elderly with compromised bone health. The perception of fracture risk from the point of view of patients and clinicians is often underestimated because osteoporosis is a silent disease until a bone fracture occurs. Despite the availability of various effective anti-osteoporosis drugs (AOD) and well-established guidelines for fracture prevention, the majority of patients who sustain low-energy bone fractures do not receive AOD. The discrepancy between the previous osteoporotic fracture and the low rate of AOD in these patients is called the fracture gap. In response to this gap in treatment, in 2012 the International Osteoporosis Foundation (IOF) launched the "Capture the Fracture" program to facilitate the implementation of coordinator-based multidisciplinary healthcare models for secondary fracture prevention. Fracture Liaison Services (FLS) models are now widely advocated as the most appropriate approach to cover all aspects of secondary fracture prevention, including patient identification, education, risk assessment, treatment and long-term follow-up. It is of great importance to prescribe diagnostic tests for the assessment of risk factors such as: laboratory tests, bone densitometry and radiography of the spine. FLS includes a multidisciplinary approach defined and structured by the integration of the medical profession, nurses and other related workers and the administration itself, with the aim of reducing the consequent risks of fractures in patients with a recent low-energy osteoporotic fracture. The healthcare system is beginning to ascribe more importance to its utility and other benefits, and prioritizes secondary versus primary prevention as well as fall prevention, in which the investment-gain ratio in the context of healthcare is apparently smaller. In this work we present a pivotal FLS program developed in the Sisters of Charity University Clinical Hospital in Zagreb (Croatia).
Keywords
steoporotic fracture; bone fracture; secondary prevention; health services
Hrčak ID:
291571
URI
Publication date:
17.1.2023.
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