Post-fracture Care Gap

By missing the opportunity to respond to the first fracture, healthcare systems around the world are failing to prevent the second and subsequent fractures.

Kristina Åkesson
Professor, Sweden

There is a post fracture care gap in secondary prevention for fracture patients around the world. Consistently, studies of health care systems from country to country indicate that fragility fracture patients:

• Fail to be tested for osteoporosis
• Remain untreated for osteoporosis
• Lack prescriptions for osteoporosis specific medication
• Are not diagnosed nor documented
• Go on to break another bone

Sadly, this illustrates the reality that most hospitals and clinics fail to ‘capture’ that first fracture – leaving patients open to a future of suffering and debility.  Over 80% of fracture patients are never offered screening and/or treatment for osteoporosis, despite the fact that there are effective medications that can reduce fracture risk by as much as 30 – 70%.

A study from the Netherlands concludes:

...the results of this study suggest that treatment for osteoporosis for post-fracture patients in current practice is still quite appalling.

A study from The Royal College of Physicians concluded:

The majority of high-risk patients miss the best or only opportunity for their falls and fracture risk to be identified in the majority of hospitals and most primary care organisations lack adequate services for secondary falls and fracture prevention.

The clear message is that regardless of the specific structure of the particular healthcare system, fragility fracture patients routinely fail to receive secondary preventive care.