Ireland’s Osteoporosis Crisis: 70% of Patients Not Receiving Proper Treatment

A new study from the University of Galway has revealed a shocking truth about osteoporosis treatment in Ireland: up to 70% of patients are not receiving the appropriate care they need.

The study, which analyzed data from over 5,000 individuals referred to the Galway University Hospital Osteoporosis service, found a significant “treatment gap.” This gap highlights a concerning trend of over-treatment for those at low risk and under-treatment for those most vulnerable to the debilitating effects of osteoporosis.

Over-Prescribing and Under-Treatment: A Stark Reality

The research uncovered several alarming findings:

• Calcium and Vitamin D Overprescribing: While calcium and vitamin D are essential for bone health, the study found they are widely prescribed for individuals concerned about their bone health, even when there’s no clear need. These supplements, although beneficial for some, can be costly and even increase the risk of fractures in certain individuals.
• Costly Misallocation of Resources: Calcium and vitamin D prescriptions surpass osteoporosis medication prescriptions, costing approximately the same (€100 – €300 per year). This raises concerns about the allocation of healthcare resources when more effective treatments exist.
• “Low Risk” Patients Receiving Unnecessary Medication: Numerous individuals categorized as “low risk” for osteoporosis are prescribed medications they don’t require, potentially exposing them to unnecessary side effects and costs.
• Missed Opportunities for Treatment: The majority of individuals who should benefit most from osteoporosis medication are not receiving it. This neglect leaves them vulnerable to fractures and the long-term consequences of the disease.

The study’s lead researcher, Prof. John Carey, emphasizes the urgency of addressing this issue:

“We regularly see patients in clinic who had a DXA test they did not require, following which a poor quality report and interpretation led to overtreatment and sometimes significant harm to the patient and all of the associated costs,” said Prof Carey.

“On the other hand, we regularly see patients who have had a fracture and sometimes low or very low bone mineral density (BMD) who are not treated, despite multiple recommendations and overwhelming evidence that this is the group of people mostly likely to benefit from treatment.

“Furthermore, Calcium and Vitamin D are widely prescribed and overused, in the mistaken belief that they are a treatment for osteoporosis, which they are not. They are essential for good bone health, but only a treatment for deficiency or frank osteomalacia,” he added.

“A national programme which collates and is led by national experts and harmonises care based on standards and best practice for clinical staff and patients would significantly reduce waste and provide better quality care and value for money. This is something the Government should be striving for.”

The Need for a National Osteoporosis Strategy

Ireland currently lacks a dedicated osteoporosis programme, despite the disease’s significant impact on the population. Osteoporosis is one of the most prevalent and debilitating conditions in the country, accounting for nearly 10% of the healthcare budget.

The findings of this study underscore the urgent need for a comprehensive national osteoporosis strategy. Such a program would:

• Improve diagnosis and treatment guidelines
• Educate healthcare professionals and the public about osteoporosis
• Ensure equitable access to appropriate care
• Optimize resource allocation and reduce unnecessary costs

By addressing these critical issues, Ireland can take significant strides towards improving the lives of individuals living with osteoporosis.

Do you or a loved one have concerns about osteoporosis? Talk to your doctor about the risks and potential treatments available.