Bone Fracture Risk: Experts Warn of Treatment Gap
Up to 70% of people at very high risk of bone fracture are not receiving adequate treatment, according to researchers at the University of Galway. This alarming statistic highlights a concerning gap between unnecessary overtreatment and undertreatment of osteoporosis.
Between 300,000 and 500,000 people in Ireland have osteoporosis, a condition that weakens bones and increases the risk of fractures. Osteoporosis is a leading cause of patients ending up in emergency departments.
Calcium and Vitamin D: Not a Cure for Osteoporosis
Professor John Carey, a specialist in osteoporosis diagnosis and treatment at University of Galway, emphasizes that while calcium and vitamin D are essential for bone health, they are not a treatment for osteoporosis.
“Calcium and vitamin D prescribing outstrips osteoporosis medication prescribing, despite costing around the same,” Prof. Carey stated. “Calcium and vitamin D are essential for good bone health, but are only a treatment for those who are low in both or have osteomalacia, where someone has soft bones.”
The Problem with DXA Scans
Prof. Carey points to poor quality DXA scans, which measure bone mineral density, as a contributing factor to the issue. He explains that these scans can lead to “false positives,” resulting in younger individuals being wrongly diagnosed with osteoporosis and unnecessarily prescribed medication.
“You cannot diagnose osteoporosis on the basis of a DXA scan alone. It is more complicated. There are false positives and it is linked to lack of training,” Prof. Carey warned.
“Women and men in their 30s, 40s and 50s are getting DXA scans, which are sometimes of very poor quality. It has knock-on effects. They are put on treatment and they are ending up with complications and significant harm.
Underdiagnosis and Undertreatment
Prof. Carey highlights the other side of the coin: patients who have experienced bone fractures and have low bone mineral density are often not treated despite clear recommendations and strong evidence supporting treatment.
“On the other hand, we regularly see patients who have had a fracture and sometimes low or very low bone mineral density who are not treated, despite multiple recommendations and overwhelming evidence that this is the group of people mostly likely to benefit from treatment.”
Call for Action
Professor Carey calls for a national program to address this “chaotic” system, including:
* Increased access to DXA scanners in public hospitals.
* Improved training for healthcare professionals on osteoporosis diagnosis and treatment.
* A focus on identifying and treating those at highest risk of fracture.
**Don’t wait until it’s too late. Talk to your doctor about your risk of osteoporosis and learn more about available treatment options.**