Up to 70% of osteoporosis patients receive inappropriate treatment, research shows – The Irish Times

Doctors have called for a national osteoporosis strategy after new research found that 70 percent of patients do not receive appropriate treatment, and that osteoporotic fractures are one of the main reasons for acute hospital admissions.

Osteoporosis is a condition that causes large holes to form in the bones, making them prone to breaking. According to the Irish Osteoporosis Society, around 300,000 people in Ireland suffer from osteoporosis, yet only around 19 percent of people are diagnosed with it.

A team of doctors and academics from the University of Galway carried out an analysis of findings from a survey of more than 5,000 men and women referred to Galway University Hospital’s osteoporosis service.

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They said the research, published to mark World Osteoporosis Day on Sunday, reveals the extent of the overtreatment of people at low risk of osteoporosis and the undertreatment of those most in need of medication.

The results showed that the majority of men (70 percent) and women (54 percent) at very high risk of fracture do not undergo treatment, while an even greater proportion of men (80 percent) and those at risk , not receiving treatment. Women at risk (70 percent) do not receive appropriate treatment.

Ireland does not have an osteoporosis program, although the bone disease is one of the most common and disabling diseases in Ireland, accounting for almost 10 percent of the health care budget.

The research team said a national osteoporosis program would help tackle these anomalies, reduce healthcare waste, prevent harm from overdiagnosis and overprescribing, and improve appropriate prescribing for those most likely to benefit.

Professor John Carey, one of the lead researchers from the University of Galway, said over-prescribing in low-risk people has led to a “wrong impression – an ecological fallacy – that the treatment gap we have for osteoporosis patients in Ireland is actually quite small is. ”.

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“When treatment indications are taken into account, the gap remains unacceptably large,” he said.

“A national osteoporosis program would help tackle these abnormalities, reduce waste and harm to patients and improve treatment for those most likely to benefit. This would significantly improve the quality of care and value for money.”

The study found that calcium and vitamin D are widely prescribed to people concerned about their bone health.

This is despite ‘very strong evidence’ that while additional supplementation has benefits for the majority of people, it ‘incurs significant costs and can cause harm’, including an increase in the risk of fractures.

Prescribing calcium and vitamin D exceeds prescribing osteoporosis medications, and costs about the same as osteoporosis medications, which have “very strong evidence” to support their use.

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Many low-risk men and women are prescribed osteoporosis medications who don’t need them, the study found, while the majority of people who should receive osteoporosis medications do not.

The research team estimated that the actual gap for patients who do not receive appropriate treatment is approximately 60 to 70 percent.

Doctors, computer scientists and engineers at the University of Galway use modern scanning technology to assess a person’s risk before a fracture occurs, as well as assess their prognosis and monitor treatment.

“We regularly see patients in the clinic who have had a test they did not need, only for a poor quality report and interpretation to result in over-treatment and sometimes significant harm to the patient and all associated costs,” said Prof. Carey.

He said a national program would “significantly reduce waste and provide better quality and value for money care”, adding that it was something the Government “should strive for”.