New Survey Shows Gap in Diagnosis & Treatment of Osteoporosis Among Post-Menopausal Women Studied Who Were Hospitalized with ...

New results from a survey of 1,122 post-menopausal women in Asia found that nearly half (48.5 percent) were not aware whether or not they had osteoporosis despite being hospitalized with a fragility fracture. A fragility fracture is one potential indicator of osteoporosis, along with BMD measurements, family history and other factors, according to International Osteoporosis Foundation (IOF). Of the women who were told that they have osteoporosis (51.5 percent), 40.5 percent did not receive any treatment. The results of this survey, which was conducted in Hong Kong SAR, Thailand, South Korea, mainland China, Singapore, Malaysia and Taiwan region, were presented at the 1st Scientific Meeting of the Asian Federation of Osteoporosis Societies. The survey was conducted by MSD, also known in the United States and Canada as Merck.

A fragility fracture occurs in a non-traumatic situation where bones would not break under normal force; these fractures are often considered a strong clinical indicator in the diagnosis of osteoporosis in post-menopausal women, along with other factors considered. According to the IOF, the incidence of hip fracture has risen two-to-three-fold in most Asian countries in the past 30 years and IOF estimates that more than 50 percent of all osteoporotic hip fractures will occur in Asia by the year 2050. Guidelines from the IOF recommend that postmenopausal women with a previous hip or vertebral fracture can be considered for osteoporosis treatment along with other factors.

"This study involves data from seven Asian countries/regions to document the treatment gap of fracture patients," said Professor Annie Kung, lead investigator. "It reminds us of the urgency we have to address this important disease in Asia."

Among the patients who were diagnosed as having osteoporosis (n=576), 8.1 percent received only an osteoporosis medication, 26.5 percent received vitamin supplementations, 24.9 percent were treated with both medications and supplements and 40.5 percent did not receive any medication or vitamin supplementation. Patients aged 65-79 years were significantly more likely to receive osteoporosis medications than patients in other age groups.

Patients who received a bone mineral density (BMD) screening were more likely to receive an osteoporosis diagnosis (10.1 odds ratio) than patients who reported a prior history of fracture only (0.8 odds ratio). Similarly, patients who had a BMD test were more likely to be on osteoporosis medication (1.79 odds ratio) than those with a prior history of fracture only (1.05 odds ratio). Fracture history is one important indicator for osteoporosis screening and diagnosis.

Study design

The cross-sectional, observational study included 1,122 eligible female patients of mean age 72.9 years who were hospitalized due to a non-traumatic fracture between July 1, 2006 and June 30, 2007. Interviews were conducted face-to-face and by telephone during a 6-month period following hospitalization to assess awareness of having osteoporosis, BMD screening and osteoporosis treatment. Patient demographics, family history, smoking, alcohol drinking, fracture history and knowledge and belief about osteoporosis were also collected in the survey.

About BMD and osteoporosis

Bone mineral density (BMD) is the amount of mineralized bone tissue in a certain volume of bone. It is measured through a non-invasive test to detect low bone density, which helps diagnose osteoporosis and predict an individual’s fracture risk. Osteoporosis, a disease in which the density and strength of bone are reduced, affects more than 75 million people in the United States, Europe, South America, Japan and Australia. The underlying mechanism for the development of osteoporosis is an imbalance in the body's natural processes of bone resorption (breakdown of existing bone at the cellular level) and bone formation (creation of new bone at the cellular level). Excessive bone resorption and inadequate bone formation can cause bones to become more porous and fragile, which in turn increases the risk of fractures. The most commonly recognized fractures associated with osteoporosis are at the hip, spine and wrist. The risk of having an osteoporosis-related fracture increases with age. One in three women over age 50 will experience an osteoporotic fracture, as will one in four men. According to the International Osteoporosis Foundation (IOF), the worldwide incidence of hip fracture is projected to increase by 240 percent in women and 310 percent in men by 2050.

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