Setting up a fracture liaison service to assess the risk of osteoporotic fractures and treatment gap in Helwan University Hospitals

Abstract

Background
In Egypt, despite the presence of numerous approved osteoporosis medications and many dual-energy X-ray absorptiometry scan facilities, only a small percentage of patients at high risk of sustaining a fragility fracture receive treatment. This significant “treatment gap” puts the highest-risk individuals at risk for developing fragility fractures. The aim of this study was to highlight patients at high risk of experiencing fragility fractures in the catchment area of Helwan University Hospitals by establishing a fracture liaison service and examining how they received their osteoporosis management and utilization of services.


Purpose
(1) To determine the treatment gap for men and postmenopausal women who have experienced a fragility fracture and (2) to look into the traits and risk factors for fractures of patients who show up with an index fragility fracture.


Results
This study included 28 individuals with fragility fractures, with 60.7% being female and 39.3% being male. The average age was 68.75 (SD ± 8.93) years. Twenty-five percent of males and 62% of postmenopausal women had an increased 10-year fracture risk [not including bone mineral density (BMD)]. A total of 83.3% of males and 62.6% of postmenopausal women did not get any osteoporosis medicines, despite being eligible for therapy. The Fracture Risk Assessment Tool score and BMD measurements at the hip and spine showed a significant correlation.
Fracture risk was significantly correlated with falls, sarcopenia, and functional disability.


Conclusion
In the Helwan University Hospitals catchment area, there exists a significant treatment gap for older adults in Egypt. The discrepancy appears to be linked to inadequate patient education and a poor diagnosis rate for osteoporosis.