Harmonization of Osteoporosis Guidelines: Paving the Way for Disrupting the Status Quo in Osteoporosis Management in the Asia Pacific

Abstract

In the Asia Pacific (AP) region, osteoporosis and its consequence of fragility fractures are not widely recognized as a major public health problem. Several challenges including underdiagnosis and undertreatment exist. The Asia Pacific Consortium on Osteoporosis (APCO) is a nonpartisan and apolitical organization comprising musculoskeletal experts and stakeholders from both private and public sectors who have united to develop tangible solutions for these substantive challenges. APCO's vision is to reduce the burden of osteoporosis and fragility fractures in the AP region. Heterogeneity in both scope and recommendations among the available clinical practice guidelines (CPGs) contribute to the large osteoporosis treatment gap in the Asia Pacific. APCO has therefore developed a pan Asia‐Oceania harmonized set of standards of care (The Framework), for the screening, diagnosis, and management of osteoporosis. First, a structured analysis of the 18 extant AP CPGs was completed. Subsequently, a prioritization of themes and agreement on fundamental principles in osteoporosis management were made through a Delphi process of consensus building. This approach, ensuring the opinions of all participating members were equally considered, was especially useful for a geographically diverse group such as APCO. It is hoped that the Framework will serve as a platform upon which new AP national CPGs can be developed and existing ones be revised. APCO is currently embarking on country‐specific engagement plans to embed the Framework in clinical practice in the AP region. This is through partnering with regulatory bodies and national guidelines development authorities, through peer‐to‐peer health care professional education and by conducting path finder audits to benchmark current osteoporosis services against the Framework standards. The principles underpinning the harmonization of guidelines in the AP region can also be utilized in other parts of the world that have similar socioeconomic diversity and heterogeneity of healthcare resources. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

Deep learning in the radiologic diagnosis of osteoporosis: a literature review

“… 1 The clinical consequences of osteoporosis include bone fracture, which poses various health, economic, and social problems. 2 , 3 Dual-energy X-ray absorptiometry (DXA) or quantitative CT (QCT) are considered the gold standard for diagnosing osteoporosis by measuring bone mineral density (BMD). 4 – 8 Osteoporosis is a multifactorial disease with clinical risk factors that include age, sex, weight, previous fracture, smoking, excessive drinking, and use of glucocorticoids.…”

Exercise to Prevent and Manage Frailty and Fragility Fractures

“…Due to population ageing, there are an increasing number of older adults living with chronic musculoskeletal conditions, particularly osteoporosis [1]. Fractures linked to osteoporosis -known as fragility fractures -are showing a rapid increase in incidence globally [2,3].…”

“…Fragility fractures and frailty are both preventable. Many of the age-related changes in musculoskeletal health and function seen with advancing age, such as loss of bone mineral density (BMD), muscle mass, strength, and function, are largely due to a lack of physical activity and sedentary lifestyles [1,6,16,17]. Indeed, physical inactivity in midlife has been strongly associated with an increased risk of frailty [18] and osteoporosis [6,19] in older age.…”

Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX

“…Access to quality risk assessment, diagnosis, and treatment of osteoporosis is heterogeneous and inadequate around the globe [ 1 – 3 , 11 – 17 ]. Many algorithms are available to decide whom to test, how to assess fracture risk, when to intervene, and how to monitor the effects of interventions [ 1 – 3 , 12 , 15 , 16 , 18 – 21 ]. Their performance varies considerably among different populations, with no single method substantially superior to others [ 18 – 22 ].…”