Osteoporosis and fragility fractures

Osteoporosis is a chronic disease that weakens bones and leaves people at risk of a fragility fracture. It is expected to become more common in Europe as populations age.

Context

Osteoporosis is a disease characterised by a reduction in the density of bone tissues, eventually leading to bone fragility and susceptibility to fractures.

Fragility fractures can be life-changing, often bringing pain, isolation and dependency. Every day, there are almost 10,000 fragility fractures in the EU, and most are among women over the age of 50.

While osteoporosis is more prevalent among women than men, the perception that it affects only women is misguided. Globally, 1 in 2 women and 1 in 5 men aged over 50 will experience a fragility fracture in their lifetime. Fragility fractures are a major cause of preventable deaths and disability, representing a significant economic burden on healthcare systems and societies – and this burden will only increase as populations age.

When osteoporosis is identified early and measures such as lifestyle changes and medication are put in place, further loss of bone density can be slowed or reversed, also reducing the risk of a fragility fracture. Yet people with osteoporosis are too often failed by healthcare systems, and too many preventable fractures occur. Across Europe, almost 70% of women over 70 who have osteoporosis have not been diagnosed, and even after a fracture, as many as 60–85% do not receive treatment to prevent subsequent fractures from occurring.

Osteoporosis and fragility fractures are a major public health issue. Lifelong prevention, timely intervention and appropriate multidisciplinary management can protect people from developing osteoporosis and minimise their risk of a fracture, improving quality of life for millions of people.

What we’ve achieved

HPP established five building blocks of an effective policy response to the challenge posed by osteoporosis and fragility fractures. We started with desk research and assembled a Working Group and Parliamentary Forum of European experts and policymakers. The groups met at two round-table events in 2019, in London and Brussels, to discuss the research and develop a policy toolkit. HPP also interviewed a range of experts, including carer representatives, healthcare professionals and healthy ageing advocates.

This work culminated in Osteoporosis and fragility fractures: a policy toolkit, with a call to action for policymakers working at the European, national and regional levels. The toolkit includes case studies of best practice, supporting resources for policymakers and ten individual country profiles: Belgium, Finland, France, Germany, Ireland, Italy, the Netherlands, Romania, Spain and the UK. HPP also produced a video to support the launch of the toolkit, featuring experts from the project’s Working Group and Parliamentary Forum.

We created infographics and social media content for each of the ten countries, produced in the local language, to help promote the work.

Following the launch of the policy toolkit, several of the experts involved agreed to become members of a new Osteoporosis and Fragility Fracture Policy Network. HPP runs the secretariat, including the dedicated website, and has led events such as a policy round table and a pre-recorded symposium session at the virtual World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2020).

In 2021, we added new country profiles and infographics for four additional countries: Bulgaria, Croatia, Greece and Portugal. Our work with the Network continues.

Key partners and stakeholders

Working Group and Parliamentary Forum:

  • John Bowis, Honorary Patron, Health First Europe; Former Health Minister, UK; Member of the European Parliament for the UK
  • Cyrus Cooper, President, International Osteoporosis Foundation; Professor of Rheumatology and Director, MRC Lifecourse Epidemiology Unit; Vice-Dean of Medicine, University of Southampton; Professor of Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
  • Penilla Gunther, Project Manager, FOKUS Patient; Former Member of Parliament, Sweden
  • Marian Harkin, Former Member of the European Parliament for Ireland
  • Paul Mitchell, Communications Director, Fragility Fracture Network; Honorary Departmental Senior Research Fellow, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
  • Adrian Sanders, Secretary General Parliamentarians for Diabetes Global Network; Former Member of Parliament, UK

Experts who were interviewed and those who provided review, feedback and/or comments on drafts:

  • Clive Bowman, Visiting Professor of Gerontology, School of Health Sciences, City, University of London, UK
  • Karsten Dreinhöfer, Chair, Global Alliance for Musculoskeletal Health of the Bone and Joint Decade (G-Musc); Professor, Department of Orthopedics and Traumatology Medical Park Berlin Humboldtmühle and Charité Universitätsmedizin Berlin, Germany
  • Mickaël Hiligsmann, Associate Professor of Health Economics and Health Technology Assessment, Maastricht University, the Netherlands
  • Timo Jämsä, President, European Alliance for Medical and Biological Engineering & Science; Professor, Medical Technology, University of Oulu, Finland
  • Nadia Kamel, Project Officer, Eurocarers
  • Andréa Marques, Professor, Nursing School of Coimbra; Registered Nurse of Rheumatology, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Maria Teresa Parisotto, Chief Nurse Advisor, Fresenius Medical Care; upcoming Executive Director, European Specialist Nurses Organisation
  • Didier Poivret, Rheumatologist, Regional Hospital Metz-Thionville, France
  • Wolfhart Puhl, Professor Emeritus, University Ulm, Germany; Past President, European Federation of National Associations of Orthopaedics and Traumatology
  • Marcel Smeets, Senior Consultant, European Ageing Network
  • Stecy Yghemonos, Director, Eurocarers

 

Experts interviewed for country profiles:

  • Casandra Cristea, Project Manager, C’entro associazione, Italy
  • Ansa Holm, Executive Director, Finnish Osteoporosis Association, Finland
  • Conor Hurson, Clinical Orthopaedic Lead, Irish Hip Fracture Database, Ireland
  • M Kassim Javaid, Associate Professor in Metabolic Bone Disease, University of Oxford, UK
  • Andreas Kurth, Professor, Campus Kemperhof, Community Clinics Middle Rhine; Chairman, Dachverband Osteologie, Germany
  • Michaël Laurent, Board Member, Belgian Bone Club; Consultant, Centre for Metabolic Bone Diseases, University Hospitals Leuven; Attending Geriatrician, Department of Geriatrics, Imelda Hospital Bondheiden, Belgium
  • Jan van Megen, Senior Director Marketing & Academy Europe, Arjo, Netherlands
  • Moira O’Brien, Emeritus Professor of Anatomy, Trinity College Dublin; President, Irish Osteoporosis Society, Ireland
  • Diana Păun, Associate Professor of Endocrinology, CI Parhon National Institute of Endocrinology, Carol Davila University of Medicine and Pharmacy, Romania
  • Olli Simonen, Chairman, Finnish Osteoporosis Society, Finland
  • Pauliina Tamminen, Self-management Coordinator, Finnish Osteoporosis Association, Finland
  • Sari Tervonen, Executive Director, Carers Finland, Finland
  • Thierry Thomas, Professor of Medicine and Head of Rheumatology, University Hospital St Etienne, France
  • Anne Thurston, Head of Quality Improvement, Royal Osteoporosis Society, UK

Project funding

This project was initiated and funded by Amgen (Europe) GmbH.

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