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Patient awareness and preventive screening could cut osteoporosis fractures, researchers say

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More osteoporosis fractures could be prevented with better awareness among patients, according to a review by researchers at the University of Missouri School of Medicine.

Dr Brett Crist and Dr Kyle Schweser examined recent osteoporosis treatment and management options with the goal of preventing complications from the disease. They found that, although comprehensive care for fragility fractures is available to patients, their understanding of risk factors, treatment adherence and the use of preventive screening remains low.

According to the UK’s National Osteoporosis Society, it’s estimated that around 3 million people in the UK have osteoporosis. The condition can lead to bones becoming fragile and breaking easily, resulting in pain and disability. As many as one in two women and one in five men over the age of 50 will break a bone as a result of osteoporosis. But much can be done to treat osteoporosis and prevent fractures.

“A fracture is the only true symptom of osteoporosis, and typically, that’s how the disease is diagnosed,” said Dr Crist, associate professor of orthopaedic surgery at the MU School of Medicine and senior author of the review. “Knowing risk factors — age, gender and family history — allows us to screen for osteoporosis and prevent complications. However, in our review, we found that preventable complications, such as secondary fractures, are more common than they should be. The reality is that death and disability associated with osteoporosis affect more people than most cancers. Previous research shows that the mortality rate for the elderly is 30% up to one year following a hip fracture.”

Dr Crist, who also serves as an orthopaedic trauma surgeon at MU Health Care, wants to see greater use of preventive screening for osteoporosis.

“The risk of decreased bone density starts at age 50, so it’s appropriate to start screening patients then to maximise the benefit and cost-effectiveness of fracture prevention,” he said. “However, less than 27% of patients ages 65 to 79 are screened for the disease. Screening rates are even lower for both younger and older patient populations. Screening methods should include questionnaires and available tests for measuring bone density, such as a DEXA scan.”

Dr Crist also called for more research into the pros and cons of calcium supplementation as a treatment option, and said that medical practitioners need to have conversations with their patients about recent advances in osteoporosis treatment and management.

“Patients sometimes view osteoporosis as part of the normal ageing process,” he added. “However, they take a significant risk if they don’t fully understand the consequences of their diagnosis. The development of an interdisciplinary care plan that meets the expectations and needs of the patient is the goal.”

The review has been published in Current Reviews in Musculoskeletal Medicine.