Osteoporosis - treatment gap

Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. The definition of osteoporosis is based on the T-score for bone mineral density in women and is defined as a value for bone mineral density of 2.5 standard deviation or more below the young female adult mean (T-score less than or equal to ? 2.5). The clinical significance of osteoporosis lies in the fractures, which are usually the first clinical sign. Approximately one in two adult women and one in five men will sustain one or more fragility fractures (defined as a low trauma fracture sustained from a fall from standing height or less) in their lifetime. More than 9 million osteoporotic or fragility fractures occur annually across the globe, more than a third of which happen in Europe. It was estimated that 10.6 out of the 18.4 million women in Europe who exceeded the threshold risk for osteoporotic fractures were not treated, representing a treatment gap of 57%. The treatment gap is considered such a major concern that multiple global health organizations have issued global calls to tackle this crisis. The increase in the treatment gap could be accredited to several factors such as misbelief about osteoporosis, absence of perceived benefits of therapy, concern about side effects and medication costs, low motivation, and shortfall of patient education. Several methods have been explored to enable fracture risk assessment and initiation of appropriate therapy. The multi-disciplinary Fracture Liaison Service is one of the most successful of these systems.