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Osteoporosis in the European Union: a compendium of country-specific reports

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TLDR
In spite of the high cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by aging populations, the use of pharmacological prevention of osteeporosis has decreased in recent years, suggesting that a change in healthcare policy concerning the disease is warranted.
Abstract
This report describes epidemiology, burden, and treatment of osteoporosis in each of the 27 countries of the European Union (EU27). In 2010, 22 million women and 5.5 million men were estimated to have osteoporosis in the EU; and 3.5 million new fragility fractures were sustained, comprising 620,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures. The economic burden of incident and prior fragility fractures was estimated at € 37 billion. Previous and incident fractures also accounted for 1,180,000 quality-adjusted life years lost during 2010. The costs are expected to increase by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining. The aim of this report was to characterize the burden of osteoporosis in each of the EU27 countries in 2010 and beyond. The data on fracture incidence and costs of fractures in the EU27 were taken from a concurrent publication in this journal (Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden) and country specific information extracted. The clinical and economic burden of osteoporotic fractures in 2010 is given for each of the 27 countries of the EU. The costs are expected to increase on average by 25 % in 2025. The majority of individuals who have sustained an osteoporosis-related fracture or who are at high risk of fracture are untreated and the number of patients on treatment is declining. In spite of the high cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by aging populations, the use of pharmacological prevention of osteoporosis has decreased in recent years, suggesting that a change in healthcare policy concerning the disease is warranted.

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Medication-taking behaviour in Bulgarian women with postmenopausal osteoporosis treated with denosumab or monthly oral bisphosphonates.

TL;DR: This real-world study demonstrates there is a low discontinuation rate and high persistence with denosumab, and denosumsumab was associated with greater BMD increases than ibandronate, which could reduce fracture risk.
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Differences in Gait Performance, Quadriceps Strength, and Physical Activity Between Fallers and Nonfallers in Women with Osteoporosis.

TL;DR: Walking speed, stride length, ankle power generation, and quadriceps strength can be used to differentiate between fallers and nonfallers in women with osteoporosis.
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District nurses’ perceptions of osteoporosis management: a qualitative study

TL;DR: Osteoporosis was reported, by the district nurses, to be a low-priority condition with consequences being unawareness of the condition, insufficient knowledge about bone-specific medications, fracture risk assessment tools and procedures, and these may be some of the explanations for the undertreatment of osteoporotic.
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Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results from the EPIC-Norfolk Cohort Study

TL;DR: Clinical and public health practice in vitamin D supplementation could partially explain these findings, although definitive conclusions are difficult due to potential changes in exposure status over the long follow up period.
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Percutaneous kyphoplasty for osteoporotic vertebral compression fractures via unilateral versus bilateral approach: A meta-analysis.

TL;DR: It is presented that patients with OVCFs could obtain similar satisfactory clinical results via both unilateral and bilateral PKP approaches, and it is suggested that a unilateral PKP approach is advantageous.
References
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Unit Costs of Health and Social Care 2014

TL;DR: The 2014 edition of the PSSRU Unit-Costs series as mentioned in this paper is the latest volume in a well-established series bringing together information from a variety of sources to estimate national unit costs for a wide range of health and social care services.
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Updated Data on Proximal Femur Bone Mineral Levels of US Adults

TL;DR: The updated data on BMD for the total femur ROI of NHW have been selected as the reference database for femur standardization efforts by the International Committee on Standards in Bone Measurements.
Journal ArticleDOI

A reference standard for the description of osteoporosis.

TL;DR: This paper proposes that the reference standard should be based on bone mineral density (BMD) measurement made at the femoral neck with dual-energy X-ray absorptiometry (DXA), which has been the most extensively validated, and provides a gradient of fracture risk as high as or higher than that of many other techniques.
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Long-Term Risk of Osteoporotic Fracture in Malmö

TL;DR: It is concluded that fractures of the hip and spine carry higher risks than fractures at other sites, and that lifetime risks of fracture of the hips in particular have been underestimated.
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