toolkit - international osteoporosis...
TRANSCRIPT
IOF
IOF COMPENDIUMOF OSTEOPOROSIS
Our vision is a world without fragility fractures, in which
healthy mobility is a reality for all.
TOOLKIT
2
INTRODUCTION
In October 2017, the International Osteoporosis Foundation (IOF) will publish the first IOF Compendium of Osteoporosis, which will be updated frequently. The IOF Compendium of Osteoporosis provides a summary of current knowledge of bone biology and risk factors which pre-dispose individuals to suffer fragility fractures, the clinically significant consequence of osteoporosis. The burden imposed by osteoporosis – from epidemiological, quality of life and socio-economic perspectives – are documented at the global and regional level. Preventive strategies, including the role of nutrition in maintaining bone health throughout life is considered. Evidence for the effectiveness of treatments is reviewed and will be expanded as new research is published and new therapies become available. Public awareness of benefits versus risks of treatment are analysed. Considerable activity is ongoing worldwide to establish models of care which ensure that the right patient receives the right treatment at the right time. The Compendium describes how these services are organised and the outcomes that they achieve. Finally, and perhaps most importantly, a Blueprint for Action provides all stakeholders with clear recommendations for achieving optimal bone health for all. The Blueprint will lead to widespread implementation of proven models of care, better education for healthcare professionals, greater public awareness, improved access to diagnosis and treatment and formation of new national alliances.
3
An outline of a communications plan and supporting documentation which can be adapted for national use by individual societies.
Template articles, web content and social media posts which the national societies could offer to feature in the various organisations’ newsletters and/or internet channels and/or social media.
We hope that this Toolkit will help to make World Osteoporosis Day 2017 the most impactful to date. IOF would be delighted to receive your feedback and suggestions for future campaigns at:[email protected].
The IOF Compendium is intended to serve as a reference point for all key stakeholders within the field of musculoskeletal health, including national level policymakers, Government representatives, healthcare professionals and their organisations, national osteoporosis societies, the healthcare industry and the media.
To support national osteoporosis societies to maximise awareness of the IOF Compendium, IOF has developed this Advocacy Toolkit. The Toolkit includes the following resources:
4
6COMMUNICATIONS PLAN
9
APPENDIX 1TEXT FOR EMAILS OR LETTERS OF INTRODUCTION AND/OR INVITATION
POLITICIANS
HEALTHCARE QUALITY ORGANISATIONS
10
15
LEARNED SOCIETIES
PAYERS
HOSPITALS
PRIMARY CARE GROUPS
NON-GOVERNMENTAL ORGANISATIONS
21
27
33
39
45
MEDIA
PRIVATE SECTOR
48
49
CONTENTS
5
51
APPENDIX 2TEMPLATE ARTICLES, WEB CONTENT AND SOCIAL MEDIA POSTS
ARTICLES
FOR GOVERNMENT ORGANISATIONS
FOR LEARNED SOCIETIES
FOR NON-GOVERNMENTAL ORGANISATIONS
WEB CONTENT
SOCIAL MEDIA POSTS
52
63
63
52
53
55
6
COMMUNICATIONS PLAN
Under its theme of “Love Your Bones: Protect Your Future”, the World Osteoporosis Day (WOD) 2017 Campaign calls upon the general public to take early action to protect their bone and muscle health, and for health authorities and physicians to protect their communities’ bone health. To support national osteoporosis societies to maximise awareness of the IOF Compendium, IOF has developed this Advocacy Toolkit. There follows an outline of a communications plan which can be adapted for national use by individual societies.
Osteoporosis is a very common condition. Among the population aged over 50 years, one in three women and one in five men will suffer a fragility fracture. For a condition which adversely affects such a large proportion of our population, levels of awareness are remarkably low. This must change. In this regard, WOD provides an opportunity in October to increase awareness throughout the world. The process to implement an effective campaign can be summarised as the “6i’s”:
IDENTIFICATION
Who are the most influential individuals and organisations which can support your national campaign? IOF has developed the spreadsheet titled “WOD Comms Plan Master” which can be used to collate contact details and track communications. This is likely to include:
Politicians.Relevant Government organisations (e.g. Ministry of Health, Ministry for Seniors, healthcare quality organisations, etc.).Relevant learned societies (e.g. national organisations for metabolic bone disease specialists, endocrinologists, rheumatologists, geriatricians, orthopaedic surgeons, nurse specialists, etc).Payers (e.g. Single-payer, Government-managed health systems or health insurance companies).Other non-governmental organisations (NGOs) which advocate for people living with diseases where osteoporosis is a common comorbidity (e.g. respiratory, rheumatoid arthritis, prostate/breast cancer, dementia, diseases of malabsorption [celiac and Crohn’s], hypogonadism, AIDS, etc).Hospitals and primary care groups.Media.Private sector (e.g. Aged care providers, DXA manufacturers, medical devices manufacturers, pharmaceutical manufacturers.)
7
An important consideration when developing and implementing the communications plan is this: consider the influential individuals and leaders of key organisations in both their professional capacity and as a human being who has a skeleton. Every President or Prime Minister needs to be aware of their own bone health, just as much as the individuals who make up the population that they serve.
INTRODUCTION
While national societies are likely to have established connections with some of these individuals and organisations, where this is not the case, an initial introduction must be made. In this regard, Appendix 1 provides text for emails or letters of introduction.
INVITATION
National societies can invite individuals and organisations to use their communications channels to disseminate articles, web content and social media posts prepared by your national osteoporosis society which relate to WOD 2017. In this regard, Appendix 2 provides template articles, web content and social media posts for a range of audiences.
INNOVATION
Consider innovative new approaches to engage as many of your fellow citizens as possible at minimal cost to your national society.
INSPIRATION
National societies should inspire their new-found supporters by describing the simple steps that can be taken to improve the bone health of the entire nation.
IMPACT
Tracking the process steps in the campaign and measuring the impact achieved is vital to making improvements in future years.
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9
APPENDIX 1TEXT FOR EMAILS OR LETTERS OF INTRODUCTION AND/OR INVITATION
The following section provides examples of different templates that can be adapted as appropriate and targeted to influential individuals and leaders of organisations in your country.
Templates have been compiled according to type of influence.
10
POLITICIANS
The following text could be adapted for an email or letter to the President/Prime Minister, leaders of opposition parties, Ministers of Health, opposition health spokespersons, Ministers of Finance, opposition finance spokespersons, Ministers of Social Development and opposition social development spokespersons.
11
A summary of current knowledge of bone biology and risk factors which pre-dispose
individuals to suffer fragility fractures, the clinically significant consequence of osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone
health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target
treatments to individuals at high fracture risk, and the global and regional burden of
osteoporosis.
A Blueprint for Action provides all stakeholders with clear recommendations for achieving
optimal bone health for all.
Dear Mr./Mrs. President/Prime Minister,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of my
colleagues at your national osteoporosis society.
October is the month each year that national osteoporosis charities collaborate with our
colleagues at the International Osteoporosis Foundation (IOF) to drive awareness of the
global World Osteoporosis Day (WOD) Awareness Campaign.
This year, a centrepiece of the Campaign is publication of first IOF Compendium of
Osteoporosis, which will be updated frequently. The IOF Compendium is intended to serve
as a reference point for all key stakeholders within the field of musculoskeletal health
globally and provides:
Osteoporosis is the most common bone disease. One in three women aged 50 years and over
will sustain a fragility fracture, as will one in five men. Fragility fractures impose a tremendous
burden on our older people, their families and carers, and our economy. In your country, every
year XX,XXX people fracture their hip, resulting in Y,YYY premature deaths and $Z million
expenditure on health and social care. As our population ages, the impact of osteoporosis on
our older people and health budgets is set to rise dramatically.
However, there is reason for optimism. Osteoporosis can be readily diagnosed and fracture
risk is easily accessed. A broad range of effective treatments are available throughout the
world that have been shown to reduce the risk of hip, vertebral and other fragility fractures.
Effective models of care have been developed in many countries to ensure that the right
patient receives the right treatment at the right time. In recent years, national alliances –
comprised of policymakers, healthcare professional organisations and national osteoporosis
societies - have been formed in a growing number of countries to combine expertise, resources
and the desire to improve outcomes for those who have sustained fragility fractures.
[Insert a summary of the current “state of your nation” with respect to the 8 priorities
highlighted in the IOF Compendium which are of relevance to the situation in your country:
PRIORITY 1: SECONDARY FRACTURE PREVENTION
Policymakers, healthcare professional organisations and national osteoporosis societies must
collaborate to provide Orthogeriatrics Services and Fracture Liaison Services to all older people
who suffer fragility fractures in their jurisdictions.
PRIORITY 2: OSTEOPOROSIS INDUCED BY MEDICINES
Where treatments are licensed to prevent osteoporosis induced by medicines, and guidelines
12
PRIORITY 6: PUBLIC AWARENESS AND EDUCATION
National osteoporosis societies, healthcare professional organisations, policymakers and
regulators to collaborate to develop impactful public awareness campaigns which empower
consumers to take ownership of their bone health.
PRIORITY 7: IMPROVING ACCESS AND REIMBURSEMENT FORDIAGNOSIS AND TREATMENT
Osteoporosis must be designated a national health priority in all countries, with
PRIORITY 5: HEALTHCARE PROFESSIONAL EDUCATION
National osteoporosis societies and healthcare professional organisations to collaborate
to develop and encourage widespread participation in national professional education
programmes designed for 3 distinct audiences: Lead Clinicians in Osteoporosis, orthopaedic
surgeons and primary care providers.
have been published to inform best clinical practice, osteoporosis management must become
a standard consideration for clinicians when prescribing medicines with bone-wasting side
effects.
PRIORITY 3: PRIMARY FRACTURE PREVENTION
National osteoporosis societies to incorporate messaging regarding self-assessment of fracture
risk with FRAX® into public awareness and education initiatives, as advocated in Priority 6.
National osteoporosis societies to collaborate with healthcare professional organisations for
primary care providers (PCPs) to jointly advocate for PCPs to routinely undertake fracture risk
assessment when interacting with patients aged 50 years and over.
PRIORITY 4: NUTRITION AND EXERCISE
Specific initiatives encompassing nutrition and exercise are required for particular age groups:
Expectant mothers: National osteoporosis societies to collaborate with national
obstetrics organisations to advise government on optimising bone health of
mothers and infants.
Children and adolescents: National osteoporosis societies to collaborate with
government Ministries of Education, national teachers’ organisations, national
nutrition foundations/councils, national dietician/nutritionist organisations,
government Ministries of Sport and Recreation, national sports councils and
relevant private sector corporations and providers to educate children and
adolescents on achieving their genetic potential for peak bone mass.
Adults and seniors: National osteoporosis societies to collaborate with
government Ministries for Seniors, national nutrition foundations/councils, national
dietician/nutritionist organisations, non-governmental organisations concerned
with seniors’ welfare and government Ministries of Sport and Recreation, national
sports councils and relevant private sector corporations and providers to inform
adults on their nutritional and exercise needs to maintain a healthy skeleton, avoid
premature bone loss and avoid malnutrition in the elderly.
13
PRIORITY 8: FORMATION OF NATIONAL FALLS AND FRACTUREPREVENTION ALLIANCES
In countries without an existing national alliance, national osteoporosis societies to initiate
dialogue with other relevant non-governmental organisations, policymakers, healthcare
professional organisations and private sector companies to propose formation of a national
falls and fracture prevention alliance modelled on successful examples from elsewhere.
Formation of a national alliance has the potential to facilitate delivery of Priorities 1-7.
Highlight your national osteoporosis society’s most pressing priority for change in your
country.]
And finally, as one of your national osteoporosis society’s objectives is to maximise
awareness of bone health for all citizens, I very much hope that you can find time in your
busy schedule to read the report. When the importance of maintaining a healthy skeleton
is finally appreciated by all, we will be a major step closer to delivering our vision of insert
your national osteoporosis society’s vision.
Best wishes,
commensurate human and financial resources to ensure that best practice is delivered for
all individuals living with this condition. In countries where the current disease burden is not
known, epidemiological studies must be commissioned as a matter of urgency.
14
15
HEALTHCARE QUALITY ORGANISATIONS
The following titled “Introduction” could be adapted to serve as an introduction of your national osteoporosis society to the leadership of national healthcare quality organisations such as:
Australian Commission on Safety and Quality in Health Care. Health Quality Ontario in Canada. Healthcare Quality Improvement Partnership in the UK. Agency for Healthcare Research and Quality in the USA.
The subsequent text titled “Invitation” could be adapted to serve as an invitation to a national healthcare quality organisation to use their communications channels to disseminate articles, web content and social media posts prepared by your national osteoporosis society which relate to WOD 2017. In this regard, Appendix 2 provides template articles, web content and social media posts for a range of audiences.
16
Dear President/Chair/Chief Executive Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of
my colleagues at your national osteoporosis society (NOS). The NOS is [insert description
of your national osteoporosis society e.g. Your national osteoporosis society (NOS) is the
only national organisation in your country specifically committed to improving the lives of
people living with osteoporosis, and preventing the fractures it causes. Your Vision, Mission
and Goals illustrate why NOS exists, and how you intend to ensure that osteoporosis care in
your country becomes an example of best practice:
Insert your Vision
Insert your Mission
Insert your Goals
October is the month each year that national osteoporosis charities collaborate with our
colleagues at the International Osteoporosis Foundation (IOF) to drive awareness of the
global World Osteoporosis Day (WOD) Awareness Campaign.
This year, a centrepiece of the Campaign is publication of first IOF Compendium of
Osteoporosis. The IOF Compendium is intended to serve as a reference point for all key
stakeholders within the field of musculoskeletal health globally and provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose
individuals to suffer fragility fractures, the clinically significant consequence of
osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone
health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target
treatments to individuals at high fracture risk, and the global and regional burden of
osteoporosis.
A Blueprint for Action provides all stakeholders with clear recommendations for
achieving optimal bone health for all.
INTRODUCTION
Osteoporosis is the most common bone disease. One in three women aged 50 years and
over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a
tremendous burden on our older people, their families and carers, and our economy. In
your country, every year XX,XXX people fracture their hip, resulting in Y,YYY premature
deaths and $Z million expenditure on health and social care. As our population ages, the
impact of osteoporosis on our older people and health budgets is set to rise dramatically.
However, there is reason for optimism. Osteoporosis can be readily diagnosed and fracture
risk is easily accessed. A broad range of effective treatments are available throughout the
world that have been shown to reduce the risk of hip, vertebral and other fragility fractures.
Effective models of care have been developed in many countries to ensure that the right
patient receives the right treatment at the right time. In recent years, national alliances –
comprised of policymakers, healthcare professional organisations and national osteoporosis
societies - have been formed in a growing number of countries to combine expertise, resources
17
and the desire to improve outcomes for those who have sustained fragility fractures.
[Insert a summary of the current “state of your nation” with respect to the 8 priorities
highlighted in the IOF Compendium which are of relevance to the situation in your country:
National osteoporosis societies to incorporate messaging regarding self-assessment of
fracture risk with FRAX® into public awareness and education initiatives, as advocated
in Priority 6. National osteoporosis societies to collaborate with healthcare professional
organisations for primary care providers (PCPs) to jointly advocate for PCPs to routinely
undertake fracture risk assessment when interacting with patients aged 50 years and over.
PRIORITY 1: SECONDARY FRACTURE PREVENTION
Policymakers, healthcare professional organisations and national osteoporosis societies
must collaborate to provide Orthogeriatrics Services and Fracture Liaison Services to all
older people who suffer fragility fractures in their jurisdictions.
PRIORITY 2: OSTEOPOROSIS INDUCED BY MEDICINES
Where treatments are licensed to prevent osteoporosis induced by medicines, and
guidelines have been published to inform best clinical practice, osteoporosis management
must become a standard consideration for clinicians when prescribing medicines with
bone-wasting side effects.
PRIORITY 3: PRIMARY FRACTURE PREVENTION
PRIORITY 4: NUTRITION AND EXERCISE
Specific initiatives encompassing nutrition and exercise are required for particular age groups:
Expectant mothers: National osteoporosis societies to collaborate with national
obstetrics organisations to advise government on optimising bone health of
mothers and infants.
Children and adolescents: National osteoporosis societies to collaborate with
government Ministries of Education, national teachers’ organisations, national
nutrition foundations/councils, national dietician/nutritionist organisations,
government Ministries of Sport and Recreation, national sports councils and
relevant private sector corporations and providers to educate children and
adolescents on achieving their genetic potential for peak bone mass.
Adults and seniors: National osteoporosis societies to collaborate with
government Ministries for Seniors, national nutrition foundations/councils, national
dietician/nutritionist organisations, non-governmental organisations concerned
with seniors’ welfare and government Ministries of Sport and Recreation, national
sports councils and relevant private sector corporations and providers to inform
adults on their nutritional and exercise needs to maintain a healthy skeleton, avoid
premature bone loss and avoid malnutrition in the elderly.
PRIORITY 5: HEALTHCARE PROFESSIONAL EDUCATION
National osteoporosis societies and healthcare professional organisations to collaborate
to develop and encourage widespread participation in national professional education
programmes designed for 3 distinct audiences: Lead Clinicians in Osteoporosis, orthopaedic
18
Highlight your national osteoporosis society’s most pressing priority for change in your
country.]
As one of your national osteoporosis society’s objectives is to maximise awareness of bone
health for all citizens, should an opportunity exist to collaborate with your communications
team, I would be grateful if you could connect me with the appropriate member of your
staff.
Best wishes,
surgeons and primary care providers.
PRIORITY 6: PUBLIC AWARENESS AND EDUCATION
National osteoporosis societies, healthcare professional organisations, policymakers and
regulators to collaborate to develop impactful public awareness campaigns which empower
consumers to take ownership of their bone health.
PRIORITY 7: IMPROVING ACCESS AND REIMBURSEMENT FORDIAGNOSIS AND TREATMENT
Osteoporosis must be designated a national health priority in all countries, with
commensurate human and financial resources to ensure that best practice is delivered for
all individuals living with this condition. In countries where the current disease burden is not
known, epidemiological studies must be commissioned as a matter of urgency.
PRIORITY 8: FORMATION OF NATIONAL FALLS AND FRACTUREPREVENTION ALLIANCES
In countries without an existing national alliance, national osteoporosis societies to initiate
dialogue with other relevant non-governmental organisations, policymakers, healthcare
professional organisations and private sector companies to propose formation of a national
falls and fracture prevention alliance modelled on successful examples from elsewhere.
Formation of a national alliance has the potential to facilitate delivery of Priorities 1-7.
19
Dear Communications Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of my
colleagues at your national osteoporosis society (NOS). Pursuant to my correspondence
with your President/Chair/Chief Executive Officer regarding the 2017 International
Osteoporosis Foundation (IOF) World Osteoporosis Day Awareness Campaign, I am keen to
explore how our organisations could collaborate to maximise the impact of the Campaign.
In this regard, we have developed a suite of resources, including draft articles for
newsletters, web content and social media posts. We would be pleased to share examples
of these with you. We would be delighted if the national healthcare quality organisation
would be prepared to disseminate these resources through your own communication
channels. Should you have a specific process and format for content in response to such
requests, we would be happy to accommodate your needs.
Best wishes,
INVITATION
20
21
LEARNED SOCIETIES
The following text titled “Introduction” could be adapted to serve as an introduction of your national osteoporosis society to the leadership of learned societies such as:
Bone and Mineral Society e.g. Japanese Society for Bone and Mineral Research Orthopaedic Nurses Association e.g. Canadian Orthopaedic Nurses Association Society for Geriatric Medicine e.g. Hong Kong Geriatrics Society College of Physicians e.g. American College of Physicians College of Surgeons e.g. Royal College of Surgeons of England Endocrine Nurses Association e.g. Endocrine Nurses’ Society of Australia College of Radiologists e.g. American College of Radiology College of Nursing e.g. Royal College of Nursing (UK) Orthopaedic Association e.g. New Zealand Orthopaedic Association Rheumatology Association e.g. Malaysian Society of Rheumatology Pharmacy Association e.g. Indian Pharmacist Association Endocrinology Association e.g. The Japan Endocrine Society Physiotherapy Association e.g. Australian Physiotherapy Association General Practitioners Association e.g. Royal New Zealand College of General Practitioners
The subsequent text titled “Invitation” could be adapted to serve as an invitation to a learned society to use their communications channels to disseminate articles, web content and social media posts prepared by your national osteoporosis society which relate to WOD 2017. In this regard, Appendix 2 provides template articles, web content and social media posts for a range of audiences.
22
Dear President/Chair/Chief Executive Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of
my colleagues at your national osteoporosis society (NOS). The NOS is [insert description
of your national osteoporosis society e.g. Your national osteoporosis society (NOS) is the
only national organisation in your country specifically committed to improving the lives of
people living with osteoporosis, and preventing the fractures it causes. Your Vision, Mission
and Goals illustrate why NOS exists, and how you intend to ensure that osteoporosis care in
your country becomes an example of best practice:
Insert your Vision
Insert your Mission
Insert your Goals
October is the month each year that national osteoporosis charities collaborate with our
colleagues at the International Osteoporosis Foundation (IOF) to drive awareness of the
global World Osteoporosis Day (WOD) Awareness Campaign.
This year, a centrepiece of the Campaign is publication of first IOF Compendium of
Osteoporosis. The IOF Compendium is intended to serve as a reference point for all key
stakeholders within the field of musculoskeletal health globally and provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose
individuals to suffer fragility fractures, the clinically significant consequence of
osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone
health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target
treatments to individuals at high fracture risk, and the global and regional burden of
osteoporosis.
A Blueprint for Action provides all stakeholders with clear recommendations for
achieving optimal bone health for all.
INTRODUCTION
[n.b. Some of the learned societies will be very aware of the epidemiology, cost burden and
evidence for interventions. Accordingly, the following 3 paragraphs should be tailored to
the individual learned society.]
Osteoporosis is the most common bone disease. One in three women aged 50 years and
over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a
tremendous burden on our older people, their families and carers, and our economy. In
your country, every year XX,XXX people fracture their hip, resulting in Y,YYY premature
deaths and $Z million expenditure on health and social care. As our population ages, the
impact of osteoporosis on our older people and health budgets is set to rise dramatically.
However, there is reason for optimism. Osteoporosis can be readily diagnosed and fracture
risk is easily accessed. A broad range of effective treatments are available throughout the
world that have been shown to reduce the risk of hip, vertebral and other fragility fractures.
Effective models of care have been developed in many countries to ensure that the right
23
patient receives the right treatment at the right time. In recent years, national alliances –
comprised of policymakers, healthcare professional organisations and national osteoporosis
societies - have been formed in a growing number of countries to combine expertise, resources
and the desire to improve outcomes for those who have sustained fragility fractures.
[Insert a summary of the current “state of your nation” with respect to the 8 priorities
highlighted in the IOF Compendium which are of relevance to the situation in your country:
National osteoporosis societies to incorporate messaging regarding self-assessment of
fracture risk with FRAX® into public awareness and education initiatives, as advocated
in Priority 6. National osteoporosis societies to collaborate with healthcare professional
organisations for primary care providers (PCPs) to jointly advocate for PCPs to routinely
undertake fracture risk assessment when interacting with patients aged 50 years and over.
PRIORITY 1: SECONDARY FRACTURE PREVENTION
Policymakers, healthcare professional organisations and national osteoporosis societies must
collaborate to provide Orthogeriatrics Services and Fracture Liaison Services to all older people
who suffer fragility fractures in their jurisdictions.
PRIORITY 2: OSTEOPOROSIS INDUCED BY MEDICINES
Where treatments are licensed to prevent osteoporosis induced by medicines, and guidelines
have been published to inform best clinical practice, osteoporosis management must become
a standard consideration for clinicians when prescribing medicines with bone-wasting side
effects.
PRIORITY 3: PRIMARY FRACTURE PREVENTION
PRIORITY 4: NUTRITION AND EXERCISE
Specific initiatives encompassing nutrition and exercise are required for particular age groups:
Expectant mothers: National osteoporosis societies to collaborate with national
obstetrics organisations to advise government on optimising bone health of
mothers and infants.
Children and adolescents: National osteoporosis societies to collaborate with
government Ministries of Education, national teachers’ organisations, national
nutrition foundations/councils, national dietician/nutritionist organisations,
government Ministries of Sport and Recreation, national sports councils and
relevant private sector corporations and providers to educate children and
adolescents on achieving their genetic potential for peak bone mass.
Adults and seniors: National osteoporosis societies to collaborate with
government Ministries for Seniors, national nutrition foundations/councils, national
dietician/nutritionist organisations, non-governmental organisations concerned
with seniors’ welfare and government Ministries of Sport and Recreation, national
sports councils and relevant private sector corporations and providers to inform
adults on their nutritional and exercise needs to maintain a healthy skeleton, avoid
premature bone loss and avoid malnutrition in the elderly.
PRIORITY 5: HEALTHCARE PROFESSIONAL EDUCATION
National osteoporosis societies and healthcare professional organisations to collaborate to
24
develop and encourage widespread participation in national professional education
programmes designed for 3 distinct audiences: Lead Clinicians in Osteoporosis, orthopaedic
surgeons and primary care providers.
PRIORITY 6: PUBLIC AWARENESS AND EDUCATION
National osteoporosis societies, healthcare professional organisations, policymakers and
regulators to collaborate to develop impactful public awareness campaigns which empower
consumers to take ownership of their bone health.
PRIORITY 7: IMPROVING ACCESS AND REIMBURSEMENT FORDIAGNOSIS AND TREATMENT
Osteoporosis must be designated a national health priority in all countries, with
commensurate human and financial resources to ensure that best practice is delivered for
all individuals living with this condition. In countries where the current disease burden is not
known, epidemiological studies must be commissioned as a matter of urgency.
PRIORITY 8: FORMATION OF NATIONAL FALLS AND FRACTUREPREVENTION ALLIANCES
In countries without an existing national alliance, national osteoporosis societies to initiate
dialogue with other relevant non-governmental organisations, policymakers, healthcare
professional organisations and private sector companies to propose formation of a national
falls and fracture prevention alliance modelled on successful examples from elsewhere.
Formation of a national alliance has the potential to facilitate delivery of Priorities 1-7.
Highlight your national osteoporosis society’s most pressing priority for change in your
country.]
As one of your national osteoporosis society’s objectives is to maximise awareness of bone
health for all citizens, should an opportunity exist to collaborate with your communications
team, I would be grateful if you could connect me with the appropriate member of your
staff.
Best wishes,
25
Dear Communications Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of my
colleagues at your national osteoporosis society (NOS). Pursuant to my correspondence
with your President/Chief Executive Officer regarding the 2017 International Osteoporosis
Foundation (IOF) World Osteoporosis Day Awareness Campaign, I am keen to explore how
our organisations could collaborate to maximise the impact of the Campaign.
In this regard, we have developed a suite of resources, including draft articles for
newsletters, web content and social media posts. We would be pleased to share examples
of these with you. We would be delighted if the learned society would be prepared to
disseminate these resources through your own communication channels. Should you have
a specific process and format for content in response to such requests, we would be happy
to accommodate your needs.
Best wishes,
INVITATION
26
27
PAYERS
In countries which have a single-payer, Government-managed health system, communication with Government Ministers is likely to address the payer in the system. In countries where health insurance companies serve as the primary payer for the health system, the text below titled “Introduction” could be adapted to serve as an introduction of your national osteoporosis society to the leadership of the health insurance companies. The subsequent text titled “Invitation” could be adapted to serve as an invitation to a health insurance company to use their communications channels to disseminate articles, web content and social media posts prepared by your national osteoporosis society which relate to WOD 2017. In this regard, Appendix 2 provides template articles, web content and social media posts for a range of audiences.
28
Dear Chief Executive Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of
my colleagues at your national osteoporosis society (NOS). The NOS is [insert description
of your national osteoporosis society e.g. Your national osteoporosis society (NOS) is the
only national organisation in your country specifically committed to improving the lives of
people living with osteoporosis, and preventing the fractures it causes. Your Vision, Mission
and Goals illustrate why NOS exists, and how you intend to ensure that osteoporosis care in
your country becomes an example of best practice:
Insert your Vision
Insert your Mission
Insert your Goals
October is the month each year that national osteoporosis charities collaborate with our
colleagues at the International Osteoporosis Foundation (IOF) to drive awareness of the
global World Osteoporosis Day (WOD) Awareness Campaign.
This year, a centrepiece of the Campaign is publication of first IOF Compendium of
Osteoporosis. The IOF Compendium is intended to serve as a reference point for all key
stakeholders within the field of musculoskeletal health globally and provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose
individuals to suffer fragility fractures, the clinically significant consequence of
osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone
health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target
treatments to individuals at high fracture risk, and the global and regional burden of
osteoporosis.
A Blueprint for Action provides all stakeholders with clear recommendations for
achieving optimal bone health for all.
INTRODUCTION
Osteoporosis is the most common bone disease. One in three women aged 50 years and
over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a
tremendous burden on our older people, their families and carers, and our economy. In
your country, every year XX,XXX people fracture their hip, resulting in Y,YYY premature
deaths and $Z million expenditure on health and social care. Fractures at other skeletal
sites add considerably to the burden imposed by osteoporosis upon our older people. As
a leading provider of health insurance in your country, as our population ages, a growing
proportion of the population that your organisation insures will sustain fragility fractures.
However, there is reason for optimism. Osteoporosis can be readily diagnosed and fracture
risk is easily accessed. A broad range of effective treatments are available throughout the
world that have been shown to reduce the risk of hip, vertebral and other fragility fractures.
Effective models of care have been developed in many countries to ensure that the right
patient receives the right treatment at the right time. In recent years, national alliances –
29
comprised of policymakers, healthcare professional organisations and national osteoporosis
societies - have been formed in a growing number of countries to combine expertise, resources
and the desire to improve outcomes for those who have sustained fragility fractures.
[Insert a summary of the current “state of your nation” with respect to the 8 priorities
highlighted in the IOF Compendium which are of relevance to the situation in your country:
National osteoporosis societies to incorporate messaging regarding self-assessment of
fracture risk with FRAX® into public awareness and education initiatives, as advocated
in Priority 6. National osteoporosis societies to collaborate with healthcare professional
organisations for primary care providers (PCPs) to jointly advocate for PCPs to routinely
undertake fracture risk assessment when interacting with patients aged 50 years and over.
PRIORITY 1: SECONDARY FRACTURE PREVENTION
Policymakers, healthcare professional organisations and national osteoporosis societies must
collaborate to provide Orthogeriatrics Services and Fracture Liaison Services to all older people
who suffer fragility fractures in their jurisdictions.
PRIORITY 2: OSTEOPOROSIS INDUCED BY MEDICINES
Where treatments are licensed to prevent osteoporosis induced by medicines, and
guidelines have been published to inform best clinical practice, osteoporosis management
must become a standard consideration for clinicians when prescribing medicines with
bone-wasting side effects.
PRIORITY 3: PRIMARY FRACTURE PREVENTION
PRIORITY 4: NUTRITION AND EXERCISE
Specific initiatives encompassing nutrition and exercise are required for particular age groups:
Expectant mothers: National osteoporosis societies to collaborate with national
obstetrics organisations to advise government on optimising bone health of
mothers and infants.
Children and adolescents: National osteoporosis societies to collaborate with
government Ministries of Education, national teachers’ organisations, national
nutrition foundations/councils, national dietician/nutritionist organisations,
government Ministries of Sport and Recreation, national sports councils and
relevant private sector corporations and providers to educate children and
adolescents on achieving their genetic potential for peak bone mass.
Adults and seniors: National osteoporosis societies to collaborate with
government Ministries for Seniors, national nutrition foundations/councils, national
dietician/nutritionist organisations, non-governmental organisations concerned
with seniors’ welfare and government Ministries of Sport and Recreation, national
sports councils and relevant private sector corporations and providers to inform
adults on their nutritional and exercise needs to maintain a healthy skeleton, avoid
premature bone loss and avoid malnutrition in the elderly.
PRIORITY 5: HEALTHCARE PROFESSIONAL EDUCATION
National osteoporosis societies and healthcare professional organisations to collaborate to
30
develop and encourage widespread participation in national professional education
programmes designed for 3 distinct audiences: Lead Clinicians in Osteoporosis, orthopaedic
surgeons and primary care providers.
PRIORITY 6: PUBLIC AWARENESS AND EDUCATION
National osteoporosis societies, healthcare professional organisations, policymakers and
regulators to collaborate to develop impactful public awareness campaigns which empower
consumers to take ownership of their bone health.
PRIORITY 7: IMPROVING ACCESS AND REIMBURSEMENT FORDIAGNOSIS AND TREATMENT
Osteoporosis must be designated a national health priority in all countries, with
commensurate human and financial resources to ensure that best practice is delivered for
all individuals living with this condition. In countries where the current disease burden is not
known, epidemiological studies must be commissioned as a matter of urgency.
PRIORITY 8: FORMATION OF NATIONAL FALLS AND FRACTUREPREVENTION ALLIANCES
In countries without an existing national alliance, national osteoporosis societies to initiate
dialogue with other relevant non-governmental organisations, policymakers, healthcare
professional organisations and private sector companies to propose formation of a national
falls and fracture prevention alliance modelled on successful examples from elsewhere.
Formation of a national alliance has the potential to facilitate delivery of Priorities 1-7.
Highlight your national osteoporosis society’s most pressing priority for change in your
country.]
As one of your national osteoporosis society’s objectives is to maximise awareness of bone
health for all citizens, should an opportunity exist to collaborate with your communications
team, I would be grateful if you could connect me with the appropriate member of your
staff.
Best wishes,
31
Dear Communications Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of my
colleagues at your national osteoporosis society (NOS). Pursuant to my correspondence
with your Chief Executive Officer regarding the 2017 International Osteoporosis Foundation
(IOF) World Osteoporosis Day Awareness Campaign, I am keen to explore how our
organisations could collaborate to maximise the impact of the Campaign.
In this regard, we have developed a suite of resources, including draft articles for
newsletters, web content and social media posts. We would be pleased to share examples
of these with you. We would be delighted if your health insurance company would be
prepared to disseminate these resources through your own communication channels.
Should you have a specific process and format for content in response to such requests, we
would be happy to accommodate your needs.
Best wishes,
INVITATION
32
33
HOSPITALS
The text below titled “Introduction” could be adapted to serve as an introduction of your national osteoporosis society to the leadership of hospitals. The subsequent text titled “Invitation” could be adapted to serve as an invitation to a hospital to use their communications channels to disseminate articles, web content and social media posts prepared by your national osteoporosis society which relate to WOD 2017. In this regard, Appendix 2 provides template articles, web content and social media posts for a range of audiences.
34
Dear Chief Executive Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of
my colleagues at your national osteoporosis society (NOS). The NOS is [insert description
of your national osteoporosis society e.g. Your national osteoporosis society (NOS) is the
only national organisation in your country specifically committed to improving the lives of
people living with osteoporosis, and preventing the fractures it causes. Your Vision, Mission
and Goals illustrate why NOS exists, and how you intend to ensure that osteoporosis care in
your country becomes an example of best practice:
Insert your Vision
Insert your Mission
Insert your Goals
October is the month each year that national osteoporosis charities collaborate with our
colleagues at the International Osteoporosis Foundation (IOF) to drive awareness of the
global World Osteoporosis Day (WOD) Awareness Campaign.
This year, a centrepiece of the Campaign is publication of first IOF Compendium of
Osteoporosis. The IOF Compendium is intended to serve as a reference point for all key
stakeholders within the field of musculoskeletal health globally and provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose
individuals to suffer fragility fractures, the clinically significant consequence of
osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone
health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target
treatments to individuals at high fracture risk, and the global and regional burden of
osteoporosis.
A Blueprint for Action provides all stakeholders with clear recommendations for
achieving optimal bone health for all.
INTRODUCTION
[n.b. Some of the learned societies will be very aware of the epidemiology, cost burden and
evidence for interventions. Accordingly, the following 3 paragraphs should be tailored to the
individual learned society.]
Osteoporosis is the most common bone disease. One in three women aged 50 years and
over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a
tremendous burden on our older people, their families and carers, and our economy. In
your country, every year XX,XXX people fracture their hip, resulting in Y,YYY premature
deaths and $Z million expenditure on health and social care. As our population ages, the
impact of osteoporosis on our older people and health budgets is set to rise dramatically.
However, there is reason for optimism. Osteoporosis can be readily diagnosed and fracture
risk is easily accessed. A broad range of effective treatments are available throughout the
world that have been shown to reduce the risk of hip, vertebral and other fragility fractures.
Effective models of care have been developed in many countries to ensure that the right
35
patient receives the right treatment at the right time. In recent years, national alliances –
comprised of policymakers, healthcare professional organisations and national osteoporosis
societies - have been formed in a growing number of countries to combine expertise, resources
and the desire to improve outcomes for those who have sustained fragility fractures.
[Insert a summary of the current “state of your nation” with respect to the 8 priorities
highlighted in the IOF Compendium which are of relevance to the situation in your country:
National osteoporosis societies to incorporate messaging regarding self-assessment of
fracture risk with FRAX® into public awareness and education initiatives, as advocated
in Priority 6. National osteoporosis societies to collaborate with healthcare professional
organisations for primary care providers (PCPs) to jointly advocate for PCPs to routinely
undertake fracture risk assessment when interacting with patients aged 50 years and over.
PRIORITY 1: SECONDARY FRACTURE PREVENTION
Policymakers, healthcare professional organisations and national osteoporosis societies
must collaborate to provide Orthogeriatrics Services and Fracture Liaison Services to all
older people who suffer fragility fractures in their jurisdictions.
PRIORITY 2: OSTEOPOROSIS INDUCED BY MEDICINES
Where treatments are licensed to prevent osteoporosis induced by medicines, and
guidelines have been published to inform best clinical practice, osteoporosis management
must become a standard consideration for clinicians when prescribing medicines with
bone-wasting side effects.
PRIORITY 3: PRIMARY FRACTURE PREVENTION
PRIORITY 4: NUTRITION AND EXERCISE
Specific initiatives encompassing nutrition and exercise are required for particular age groups:
Expectant mothers: National osteoporosis societies to collaborate with national
obstetrics organisations to advise government on optimising bone health of
mothers and infants.
Children and adolescents: National osteoporosis societies to collaborate with
government Ministries of Education, national teachers’ organisations, national
nutrition foundations/councils, national dietician/nutritionist organisations,
government Ministries of Sport and Recreation, national sports councils and
relevant private sector corporations and providers to educate children and
adolescents on achieving their genetic potential for peak bone mass.
Adults and seniors: National osteoporosis societies to collaborate with
government Ministries for Seniors, national nutrition foundations/councils, national
dietician/nutritionist organisations, non-governmental organisations concerned
with seniors’ welfare and government Ministries of Sport and Recreation, national
sports councils and relevant private sector corporations and providers to inform
adults on their nutritional and exercise needs to maintain a healthy skeleton, avoid
premature bone loss and avoid malnutrition in the elderly.
PRIORITY 5: HEALTHCARE PROFESSIONAL EDUCATION
National osteoporosis societies and healthcare professional organisations to collaborate to
36
develop and encourage widespread participation in national professional education
programmes designed for 3 distinct audiences: Lead Clinicians in Osteoporosis, orthopaedic
surgeons and primary care providers.
PRIORITY 6: PUBLIC AWARENESS AND EDUCATION
National osteoporosis societies, healthcare professional organisations, policymakers and
regulators to collaborate to develop impactful public awareness campaigns which empower
consumers to take ownership of their bone health.
PRIORITY 7: IMPROVING ACCESS AND REIMBURSEMENT FORDIAGNOSIS AND TREATMENT
Osteoporosis must be designated a national health priority in all countries, with
commensurate human and financial resources to ensure that best practice is delivered for
all individuals living with this condition. In countries where the current disease burden is not
known, epidemiological studies must be commissioned as a matter of urgency.
PRIORITY 8: FORMATION OF NATIONAL FALLS AND FRACTUREPREVENTION ALLIANCES
In countries without an existing national alliance, national osteoporosis societies to initiate
dialogue with other relevant non-governmental organisations, policymakers, healthcare
professional organisations and private sector companies to propose formation of a national
falls and fracture prevention alliance modelled on successful examples from elsewhere.
Formation of a national alliance has the potential to facilitate delivery of Priorities 1-7.
Highlight your national osteoporosis society’s most pressing priority for change in your
country.]
As one of your national osteoporosis society’s objectives is to maximise awareness of bone
health for all citizens, should an opportunity exist to collaborate with your communications
team, I would be grateful if you could connect me with the appropriate member of your
staff.
Best wishes,
37
Dear Communications Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of my
colleagues at your national osteoporosis society (NOS). Pursuant to my correspondence
with your President/Chief Executive Officer regarding the 2017 International Osteoporosis
Foundation (IOF) World Osteoporosis Day Awareness Campaign, I am keen to explore how
our organisations could collaborate to maximise the impact of the Campaign.
In this regard, we have developed a suite of resources, including draft articles for
newsletters, web content and social media posts. We would be pleased to share
examples of these with you. We would be delighted if your hospital would be prepared to
disseminate these resources through your own communication channels. Should you have
a specific process and format for content in response to such requests, we would be happy
to accommodate your needs.
Best wishes,
INVITATION
38
39
PRIMARY CARE GROUPS
The text titled “Introduction” could be adapted to serve as an introduction of your national osteoporosis society to the leadership of hospitals. The subsequent text titled “Invitation” could be adapted to serve as an invitation to a hospital to use their communications channels to disseminate articles, web content and social media posts prepared by your national osteoporosis society which relate to WOD 2017. In this regard, Appendix 2 provides template articles, web content and social media posts for a range of audiences.
40
Dear Chief Executive Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of
my colleagues at your national osteoporosis society. The NOS is [insert description of your
national osteoporosis society e.g. Your national osteoporosis society (NOS) is the only
national organisation in your country specifically committed to improving the lives of
people living with osteoporosis, and preventing the fractures it causes. Your Vision, Mission
and Goals illustrate why NOS exists, and how you intend to ensure that osteoporosis care in
your country becomes an example of best practice:
Insert your Vision
Insert your Mission
Insert your Goals
October is the month each year that national osteoporosis charities collaborate with our
colleagues at the International Osteoporosis Foundation (IOF) to drive awareness of the
global World Osteoporosis Day (WOD) Awareness Campaign.
This year, a centrepiece of the Campaign is publication of first IOF Compendium of
Osteoporosis. The IOF Compendium is intended to serve as a reference point for all key
stakeholders within the field of musculoskeletal health globally and provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose
individuals to suffer fragility fractures, the clinically significant consequence of
osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone
health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target
treatments to individuals at high fracture risk, and the global and regional burden of
osteoporosis.
A Blueprint for Action provides all stakeholders with clear recommendations for
achieving optimal bone health for all.
INTRODUCTION
[n.b. Some of the learned societies will be very aware of the epidemiology, cost burden and
evidence for interventions. Accordingly, the following 3 paragraphs should be tailored to
the individual learned society.]
Osteoporosis is the most common bone disease. One in three women aged 50 years and
over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a
tremendous burden on our older people, their families and carers, and our economy. In
your country, every year XX,XXX people fracture their hip, resulting in Y,YYY premature
deaths and $Z million expenditure on health and social care. As our population ages, the
impact of osteoporosis on our older people and health budgets is set to rise dramatically.
However, there is reason for optimism. Osteoporosis can be readily diagnosed and fracture
risk is easily accessed. A broad range of effective treatments are available throughout
the world that have been shown to reduce the risk of hip, vertebral and other fragility
fractures. Effective models of care have been developed in many countries to ensure that
41
the right patient receives the right treatment at the right time. In recent years, national
alliances – comprised of policymakers, healthcare professional organisations and national
osteoporosis societies - have been formed in a growing number of countries to combine
expertise, resources and the desire to improve outcomes for those who have sustained
fragility fractures. Osteoporosis is a long-term condition and, as such, primary care has a
critical role to play in the long-term management of osteoporosis.
[Insert a summary of the current “state of your nation” with respect to the 8 priorities
highlighted in the IOF Compendium which are of relevance to the situation in your country:
National osteoporosis societies to incorporate messaging regarding self-assessment of
fracture risk with FRAX® into public awareness and education initiatives, as advocated
in Priority 6. National osteoporosis societies to collaborate with healthcare professional
organisations for primary care providers (PCPs) to jointly advocate for PCPs to routinely
undertake fracture risk assessment when interacting with patients aged 50 years and over.
PRIORITY 1: SECONDARY FRACTURE PREVENTION
Policymakers, healthcare professional organisations and national osteoporosis societies
must collaborate to provide Orthogeriatrics Services and Fracture Liaison Services to all
older people who suffer fragility fractures in their jurisdictions.
PRIORITY 2: OSTEOPOROSIS INDUCED BY MEDICINES
Where treatments are licensed to prevent osteoporosis induced by medicines, and
guidelines have been published to inform best clinical practice, osteoporosis management
must become a standard consideration for clinicians when prescribing medicines with
bone-wasting side effects.
PRIORITY 3: PRIMARY FRACTURE PREVENTION
PRIORITY 4: NUTRITION AND EXERCISE
Specific initiatives encompassing nutrition and exercise are required for particular age groups:
Expectant mothers: National osteoporosis societies to collaborate with national
obstetrics organisations to advise government on optimising bone health of
mothers and infants.
Children and adolescents: National osteoporosis societies to collaborate with
government Ministries of Education, national teachers’ organisations, national
nutrition foundations/councils, national dietician/nutritionist organisations,
government Ministries of Sport and Recreation, national sports councils and
relevant private sector corporations and providers to educate children and
adolescents on achieving their genetic potential for peak bone mass.
Adults and seniors: National osteoporosis societies to collaborate with
government Ministries for Seniors, national nutrition foundations/councils, national
dietician/nutritionist organisations, non-governmental organisations concerned
with seniors’ welfare and government Ministries of Sport and Recreation, national
sports councils and relevant private sector corporations and providers to inform
adults on their nutritional and exercise needs to maintain a healthy skeleton, avoid
premature bone loss and avoid malnutrition in the elderly.
42
National osteoporosis societies and healthcare professional organisations to collaborate
to develop and encourage widespread participation in national professional education
programmes designed for 3 distinct audiences: Lead Clinicians in Osteoporosis, orthopaedic
surgeons and primary care providers.
PRIORITY 6: PUBLIC AWARENESS AND EDUCATION
National osteoporosis societies, healthcare professional organisations, policymakers and
regulators to collaborate to develop impactful public awareness campaigns which empower
consumers to take ownership of their bone health.
PRIORITY 7: IMPROVING ACCESS AND REIMBURSEMENT FORDIAGNOSIS AND TREATMENT
Osteoporosis must be designated a national health priority in all countries, with
commensurate human and financial resources to ensure that best practice is delivered for
all individuals living with this condition. In countries where the current disease burden is not
known, epidemiological studies must be commissioned as a matter of urgency.
PRIORITY 8: FORMATION OF NATIONAL FALLS AND FRACTUREPREVENTION ALLIANCES
In countries without an existing national alliance, national osteoporosis societies to initiate
dialogue with other relevant non-governmental organisations, policymakers, healthcare
professional organisations and private sector companies to propose formation of a national
falls and fracture prevention alliance modelled on successful examples from elsewhere.
Formation of a national alliance has the potential to facilitate delivery of Priorities 1-7.
Highlight your national osteoporosis society’s most pressing priority for change in your
country.]
As one of your national osteoporosis society’s objectives is to maximise awareness of bone
health for all citizens, should an opportunity exist to collaborate with your communications
team, I would be grateful if you could connect me with the appropriate member of your
staff.
Best wishes,
PRIORITY 5: HEALTHCARE PROFESSIONAL EDUCATION
43
Dear Communications Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of my
colleagues at your national osteoporosis society (NOS). Pursuant to my correspondence
with your President/Chief Executive Officer regarding the 2017 International Osteoporosis
Foundation (IOF) World Osteoporosis Day Awareness Campaign, I am keen to explore how
our organisations could collaborate to maximise the impact of the Campaign.
In this regard, we have developed a suite of resources, including draft articles for
newsletters, web content and social media posts. We would be pleased to share
examples of these with you. We would be delighted if your hospital would be prepared to
disseminate these resources through your own communication channels. Should you have
a specific process and format for content in response to such requests, we would be happy
to accommodate your needs.
Best wishes,
INVITATION
44
45
NON-GOVERNMENTAL ORGANISATIONS
The text titled “Introduction” could be adapted to serve as an introduction of your national osteoporosis society to the leadership of non-governmental organisations (NGOs) such as:
National Alzheimer’s Association e.g. Alzheimer’s Association® (USA) National Arthritis Association e.g. Arthritis Australia National Respiratory Association e.g. Asthma UK National Coeliac Association e.g. Coeliac New Zealand National Diabetes Association e.g. American Diabetes Association® National HIV/AIDS Association e.g. National AIDS Trust (UK) National Prostate Cancer Association e.g. Prostate Cancer Foundation of Australia National Breast Cancer Association e.g. Breast Cancer Care (UK) Senior’s Organisations e.g. Age Concern New Zealand
The subsequent text titled “Invitation” could be adapted to serve as an invitation to a learned society to use their communications channels to disseminate articles, web content and social media posts prepared by your national osteoporosis society which relate to WOD 2017. In this regard, Appendix 2 provides template articles, web content and social media posts for a range of audiences.
46
INTRODUCTION
Dear President/Chief Executive Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of
my colleagues at your national osteoporosis society. The NOS is [insert description of your
national osteoporosis society e.g. Your national osteoporosis society (NOS) is the only
national organisation in your country specifically committed to improving the lives of
people living with osteoporosis, and preventing the fractures it causes. Your Vision, Mission
and Goals illustrate why NOS exists, and how you intend to ensure that osteoporosis care in
your country becomes an example of best practice:
Insert your Vision
Insert your Mission
Insert your Goals
October is the month each year that national osteoporosis charities collaborate with our
colleagues at the International Osteoporosis Foundation (IOF) to drive awareness of the
global World Osteoporosis Day (WOD) Awareness Campaign.
This year, a centrepiece of the Campaign is publication of first IOF Compendium of
Osteoporosis. The IOF Compendium is intended to serve as a reference point for all key
stakeholders within the field of musculoskeletal health globally and provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose
individuals to suffer fragility fractures, the clinically significant consequence of
osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone
health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target
treatments to individuals at high fracture risk, and the global and regional burden of
osteoporosis.
A Blueprint for Action provides all stakeholders with clear recommendations for
achieving optimal bone health for all.
[n.b. Some of the learned societies will be very aware of the epidemiology, cost burden and
evidence for interventions. Accordingly, the following 3 paragraphs should be tailored to
the individual learned society.]
Osteoporosis is the most common bone disease. One in three women aged 50 years and
over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a
tremendous burden on our older people, their families and carers, and our economy. In
your country, every year XX,XXX people fracture their hip, resulting in Y,YYY premature
deaths and $Z million expenditure on health and social care. As our population ages, the
impact of osteoporosis on our older people and health budgets is set to rise dramatically.
[The next paragraph should be adapted for NGOs which advocate for people living
with the specific diseases mentioned above. This section is not required for Senior’s
Organisations.]
47
Osteoporosis and the fragility fractures it causes are a common among people living with
[insert the name of the condition relevant to the particular NGO.] As one of your national
osteoporosis society’s objectives is to maximise awareness of bone health for all citizens,
particularly those who are high risk of fracture, should an opportunity exist to collaborate
with your communications team to increase awareness of the WOD Awareness Campaign,
I would be grateful if you could connect me with the appropriate member of your staff.
Best wishes,
INVITATION
Dear Communications Officer,
As the Chairman of the Board/Chief Executive Officer, I am writing to you on behalf of my
colleagues at your national osteoporosis society (NOS). Pursuant to my correspondence
with your President/Chief Executive Officer regarding the 2017 International Osteoporosis
Foundation (IOF) World Osteoporosis Day Awareness Campaign, I am keen to explore how
our organisations could collaborate to maximise the impact of the Campaign.
In this regard, we have developed a suite of resources, including draft articles for
newsletters, web content and social media posts. We would be pleased to share examples
of these with you. We would be delighted if the NGO would be prepared to disseminate
these resources through your own communication channels. Should you have a specific
process and format for content in response to such requests, we would be happy to
accommodate your needs.
Best wishes,
48
MEDIA
IOF provides media releases relating to WOD which can be downloaded from the official World Osteoporosis Day Website (www.worldosteoporosisday.org).Media releases are available in multiple languages, and messaging can be adapted to meet your local country needs.The WOD website also hosts an array of media-friendly resources to accompany your press release, including infographics and factsheets.
49
PRIVATE SECTOR
National osteoporosis societies could also explore opportunities to raise awareness of the WOD Campaign among staff in private sector companies (e.g. Aged care providers, DXA manufacturers, medical devices manufacturers, pharmaceutical manufacturers.)
50
51
Relevant Government organisations (e.g. Ministry of Health, Ministry for Seniors, healthcare quality organisations, etc.).
Relevant learned societies (e.g. national organisations for metabolic bone disease specialists, endocrinologists, rheumatologists, geriatricians, orthopaedic surgeons, nurse specialists, etc).
Payers (e.g. Single-payer, Government-managed health systems or health insurance companies).
Other non-governmental organisations (NGOs) which advocate for people living with diseases where osteoporosis is a common comorbidity (e.g. respiratory, rheumatoid arthritis, prostate/breast cancer, dementia, diseases of malabsorption [celiac and Crohn’s], hypogonadism, AIDS, etc).
Hospitals and primary care groups.
APPENDIX 2TEMPLATE ARTICLES, WEB CONTENT AND SOCIAL MEDIA POSTS
There follow examples of articles for newsletters, web content and social media posts which could be provided to organisations that have agreed to support the national osteoporosis society’s WOD Awareness Campaign. These organisations include:
52
FOR GOVERNMENT ORGANISATIONS
Your national osteoporosis society marks World Osteoporosis Day on 20th October 2017.
Under its theme of Love Your Bones: Protect Your Future, the World Osteoporosis Day (WOD) 2017 Campaign calls upon the general public to take early action to protect their bone and muscle health, and for health authorities and physicians to protect their communities’ bone health.
Osteoporosis is the most common bone disease. One in three women aged 50 years and over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a tremendous burden on our older people, their families and carers, and our economy. A broad range of osteoporosis treatments, available in an array of dosing regiments, have been shown to significantly reduce the risk of hip fractures, vertebral fractures and other clinically apparent fractures.
In October, the International Osteoporosis Foundation (IOF) will publish the first IOF Compendium of Osteoporosis, which will be updated frequently. The IOF Compendium provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose individuals to suffer fragility fractures, the clinically significant consequence of osteoporosis.Preventive strategies, including the role of nutrition and exercise in maintaining bone health throughout life is considered.Updates on new osteoporosis treatments, models of care which efficiently target treatments to individuals at high fracture risk, and the global and regional burden of osteoporosis.A Blueprint for Action provides all stakeholders with clear recommendations for achieving optimal bone health for all.
Your national osteoporosis society, IOF and [insert the Seniors organisation’s name] describe the overarching objectives for good bone health at the various stages of life as:
Children and adolescents: Achieve genetic potential for peak bone mass.
Adults: Avoid premature bone loss and maintain a healthy skeleton.
Seniors: Prevent and treat osteoporosis.
The following groups should be prioritised for osteoporosis assessment and receive guidelines-based treatment:
Individuals who have sustained a fragility fracture since their 50th birthday.
People being treated with commonly used medicines which have an adverse effect on bone health (e.g. glucocorticoids, androgen deprivation therapy and aromatase inhibitors).
The [insert Seniors organisation name] commends your national osteoporosis society for their efforts to improve awareness of osteoporosis. [Insert a brief summary of the Government organisation’s policy and programmes in the bone health field.]
ARTICLES
53
FOR LEARNED SOCIETIES
Your national osteoporosis society marks World Osteoporosis Day on 20th October 2017.
Under its theme of Love Your Bones: Protect Your Future, the World Osteoporosis Day (WOD) 2017 Campaign calls upon the general public to take early action to protect their bone and muscle health, and for health authorities and physicians to protect their communities’ bone health.
Osteoporosis is the most common bone disease. One in three women aged 50 years and over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a tremendous burden on our older people, their families and carers, and our economy. A broad range of osteoporosis treatments, available in an array of dosing regiments, have been shown to significantly reduce the risk of hip fractures, vertebral fractures and other clinically apparent fractures.
In October, the International Osteoporosis Foundation (IOF) will publish the first IOF Compendium of Osteoporosis, which will be updated frequently. The IOF Compendium provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose individuals to suffer fragility fractures, the clinically significant consequence of osteoporosis.Preventive strategies, including the role of nutrition and exercise in maintaining bone health throughout life is considered.Updates on new osteoporosis treatments, models of care which efficiently target treatments to individuals at high fracture risk, and the global and regional burden of osteoporosis.A Blueprint for Action provides all stakeholders with clear recommendations for achieving optimal bone health for all.
The IOF Compendium proposes 8 key priorities to be initiated in 2017-20:
PRIORITY 1: SECONDARY FRACTURE PREVENTION
Policymakers, healthcare professional organisations and national osteoporosis societies must collaborate
to provide Orthogeriatrics Services and Fracture Liaison Services to all older people who suffer fragility
fractures in their jurisdictions.
PRIORITY 2: OSTEOPOROSIS INDUCED BY MEDICINES
Where treatments are licensed to prevent osteoporosis induced by medicines, and guidelines have
been published to inform best clinical practice, osteoporosis management must become a standard
consideration for clinicians when prescribing medicines with bone-wasting side effects.
National osteoporosis societies to incorporate messaging regarding self-assessment of fracture risk with
FRAX® into public awareness and education initiatives, as advocated in Priority 6. National osteoporosis
societies to collaborate with healthcare professional organisations for primary care providers (PCPs) to
jointly advocate for PCPs to routinely undertake fracture risk assessment when interacting with patients
aged 50 years and over.
PRIORITY 3: PRIMARY FRACTURE PREVENTION
PRIORITY 4: NUTRITION AND EXERCISE
Specific initiatives encompassing nutrition and exercise are required for particular age groups:
Expectant mothers: National osteoporosis societies to collaborate with national obstetrics
organisations to advise government on optimising bone health of mothers and infants.
Children and adolescents: National osteoporosis societies to collaborate with government
54
PRIORITY 5: HEALTHCARE PROFESSIONAL EDUCATION
National osteoporosis societies and healthcare professional organisations to collaborate to develop and
encourage widespread participation in national professional education programmes designed for 3 distinct
audiences: Lead Clinicians in Osteoporosis, orthopaedic surgeons and primary care providers.
PRIORITY 6: PUBLIC AWARENESS AND EDUCATION
National osteoporosis societies, healthcare professional organisations, policymakers and regulators
to collaborate to develop impactful public awareness campaigns which empower consumers to take
ownership of their bone health.
PRIORITY 7: IMPROVING ACCESS AND REIMBURSEMENT FORDIAGNOSIS AND TREATMENT
Osteoporosis must be designated a national health priority in all countries, with commensurate human and
financial resources to ensure that best practice is delivered for all individuals living with this condition. In
countries where the current disease burden is not known, epidemiological studies must be commissioned
as a matter of urgency.
PRIORITY 8: FORMATION OF NATIONAL FALLS AND FRACTURE PREVENTION ALLIANCES
In countries without an existing national alliance, national osteoporosis societies to initiate dialogue with
other relevant non-governmental organisations, policymakers, healthcare professional organisations and
private sector companies to propose formation of a national falls and fracture prevention alliance modelled
on successful examples from elsewhere. Formation of a national alliance has the potential to facilitate
delivery of Priorities 1-7.
The [insert learned society name] commends your national osteoporosis society for their efforts to improve awareness of osteoporosis. [Insert a brief summary of the learned society’s leading initiatives in the bone health field.]
Ministries of Education, national teachers’ organisations, national nutrition foundations/councils,
national dietician/nutritionist organisations, government Ministries of Sport and Recreation,
national sports councils and relevant private sector corporations and providers to educate children
and adolescents on achieving their genetic potential for peak bone mass.
Adults and seniors: National osteoporosis societies to collaborate with government Ministries for
Seniors, national nutrition foundations/councils, national dietician/nutritionist organisations, non-
governmental organisations concerned with seniors’ welfare and government Ministries of Sport
and Recreation, national sports councils and relevant private sector corporations and providers
to inform adults on their nutritional and exercise needs to maintain a healthy skeleton, avoid
premature bone loss and avoid malnutrition in the elderly.
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FOR NON-GOVERNMENTAL ORGANISATIONS
Your national osteoporosis society marks World Osteoporosis Day on 20th October 2017.
This month, our friends at your national osteoporosis society are supporting the International Osteoporosis Foundation’s (IOF) World Osteoporosis Day (WOD) Awareness Campaign. Under its theme of Love Your Bones: Protect Your Future, the WOD 2017 Campaign calls upon the general public to take early action to protect their bone and muscle health, and for health authorities and physicians to protect their communities’ bone health.
Osteoporosis is the most common bone disease. One in three women aged 50 years and over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a tremendous burden on our older people, their families and carers, and our economy. A broad range of osteoporosis treatments, available in an array of dosing regiments, have been shown to significantly reduce the risk of hip fractures, vertebral fractures and other clinically apparent fractures.
People who are living with [insert the disease that the particular NGO is concerned with] should be aware of their bone health. [Insert the relevant piece of text from the selection of diseases described at the end of this email/letter.]
In October, the International Osteoporosis Foundation (IOF) will publish the first IOF Compendium of Osteoporosis, which will be updated frequently. The IOF Compendium provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose individuals to suffer fragility fractures, the clinically significant consequence of osteoporosis.Preventive strategies, including the role of nutrition and exercise in maintaining bone health throughout life is considered.Updates on new osteoporosis treatments, models of care which efficiently target treatments to individuals at high fracture risk, and the global and regional burden of osteoporosis.A Blueprint for Action provides all stakeholders with clear recommendations for achieving optimal bone health for all.
If you would like to learn more visit www.worldosteoporosisday.org and check out your national osteoporosis society’s website too.
Disease specific commentary and references for the following organisations:
NATIONAL ALZHEIMER’S ASSOCIATION
In 2009, a study from the UK reported that falls occurred nine times more frequently among people living with dementia than people of the same age without dementia1. Another study among patients with Alzheimer’s disease reported the incidence of hip fracture to be almost three times higher than amongst cognitively healthy peers2. Studies from several countries have reported that osteoporosis is infrequently diagnosed and treated in people living with dementia3-6. As our population ages in the coming decades, and dementia imposes an ever-greater burden on our older citizens and their families, the need to prevent these individuals from suffering fragility fractures will become increasingly important7.
1 2
References:Incidence and prediction of falls in dementia: a prospective study in older people. PLoS One. 2009;4(5):e5521. Allan LM et al. PubMed ID 19436724
Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988-2007. Age Ageing. 2011 Jan;40(1):49-54. Baker NL et al. PubMed ID 21087990
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Dementia diagnosis and osteoporosis treatment propensity: a population-based nested case-control study. Geriatr Gerontol Int. 2014 Jan;14(1):121-9. Knopp-Sihota JA et al. PubMed ID 23992035
Incidence and Duration of Cumulative Bisphosphonate Use among Community-Dwelling Persons with or without Alzheimer’s Disease. J Alzheimers Dis. 2016;52(1):127-32. Tiihonen M et al. PubMed ID 26967224
Anti-osteoporosis drug prescribing after hip fracture in the UK: 2000-2010. Osteoporos Int. 2015 Jul;26(7):1919-28. Klop C et al. PubMed ID 25963232
Diagnosis and treatment of osteoporosis in high-risk patients prior to hip fracture. Geriatr Orthop Surg Rehabil. 2012 Jun;3(2):79-83. Gleason LJ et al. PubMed ID 23569701
Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures. Osteoporos Int. 2017 May;28(5):1507-1529. Harvey NC et al. PubMed ID 28175979
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NATIONAL ARTHRITIS ASSOCIATION
People who are living with rheumatoid arthritis (RA) have lower bone mineral density than RA-free peers, and the degree of bone loss observed is correlated with disease severity1. Pro-inflammatory cytokines released into the circulation from the inflamed synovium are thought to cause the bone loss. In 2006, a UK study evaluated fracture incidence in more than 30,000 RA sufferers2. As compared to a control group, the risk of hip fracture and vertebral fracture for the RA sufferers was increased 2-fold and 2.4-fold, respectively.
RA sufferers frequently take glucocorticoids, which are the most common cause of osteoporosis induced by medicines3. In 2011, investigators in the United States evaluated osteoporosis treatment among a large cohort of veterans with RA4. Fewer than half had received preventive treatment for osteoporosis. Similar studies from several countries5-12 have also reported sub-optimal assessment and/or treatment of osteoporosis in RA sufferers.
1 2 3 4
References:Bone mineral density in patients with rheumatoid arthritis: relation between disease severity and low bone mineral density. Ann Rheum Dis. 2004 Dec;63(12):1576-80. Lodder MC et al. PubMed ID 15547081
Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthritis. Arthritis Rheum. 2006 Oct;54(10):3104-12. van Staa TP et al. PubMed ID 17009229
Glucocorticoid-induced osteoporosis: pathophysiology and therapy. Osteoporos Int. 2007 Oct;18(10):1319-28. Canalis E et al. PubMed ID 17566815
An observational study of glucocorticoid-induced osteoporosis prophylaxis in a national cohort of male veterans with rheumatoid arthritis. Osteoporos Int. 2011 Jan;22(1):305-15. Caplan L et al. PubMed ID 20358362
There is still a care gap in osteoporosis management for patients with rheumatoid arthritis. Joint Bone Spine. 2014 Jul;81(4):347-51. Watt J et al. PubMed ID 24703625
Rates of non-vertebral osteoporotic fractures in rheumatoid arthritis and postfracture osteoporosis care in a period of evolving clinical practice guidelines. Calcif Tissue Int. 2014 Jul;95(1):8-18. Roussy JP et al. PubMed ID 24736884
Use of osteoporosis drugs in patients with recent-onset rheumatoid arthritis in Finland. Clin Exp Rheumatol. 2011 Sep-Oct;29(5):835-8. Hämäläinen H et al. PubMed ID 21961794
[Diagnosis and treatment of osteoporosis and rheumatoid arthritis in accordance with German guidelines. Results of a survey of patients, primary care physicians and rheumatologists]. Z Rheumatol. 2011 Sep;70(7):592-601. Heberlein I et al. PubMed ID 21755301
Prescription for antiresorptive therapy in Mexican patients with rheumatoid arthritis: is it time to reevaluate the strategies for osteoporosis prevention? Rheumatol Int. 2013 Jan;33(1): 145-50. Gamez-Nava JI et al. PubMed ID 22238026
The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis. BMC Musculoskelet Disord. 2016 Feb 24;17:98. Lee JH et al. PubMed ID 26912147
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References:
Osteoporosis management in patients with rheumatoid arthritis: Evidence for improvement. Arthritis Rheum. 2006 Dec 15;55(6):873-7. Solomon DH et al. PubMed ID 17139663
Screening and treatment of glucocorticoid-induced osteoporosis in rheumatoid arthritis patients in an urban multispecialty practice. J Clin Rheumatol. 2009 Mar;15(2):61-4. PubMed ID 19265346
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NATIONAL RESPIRATORY ASSOCIATION
People with asthma and chronic obstructive pulmonary disease (COPD) are often prescribed corticosteroids such as prednisone and dexamethasone to manage their respiratory condition. Unfortunately, these drugs have a negative effect on bone health. Fractures may occur in as many as 30-50% of chronic corticosteroid users1. In 2014, Canadian investigators undertook a review of osteoporosis management among chronic corticosteroid users, which included studies of people with respiratory diseases2. The majority of studies (>80%) reported that less than 40% of chronic oral corticosteroid users underwent bone mineral density testing or received osteoporosis therapy. Further, there was no evidence of improvement over time for studies conducted between 1999 and 2013.
Among people living with COPD, a systematic literature review established the average prevalence of osteoporosis to be 35%3. Vertebral fractures are particularly significant for patients with COPD. In such patients with already compromised lung function, a single vertebral fracture is estimated to reduce the vital capacity by 9%4.
1 2 3 4
References:Glucocorticoid-induced osteoporosis: pathophysiology and therapy. Osteoporos Int. 2007 Oct;18(10):1319-28. Canalis E et al. PubMed ID 17566815
Osteoporosis management among chronic glucocorticoid users: a systematic review. J Popul Ther Clin Pharmacol. 2014;21(3):e486-504. Albaum JM et al. PubMed ID 25527817
Current status of research on osteoporosis in COPD: a systematic review. Eur Respir J. 2009 Jul;34(1):209-18. Graat-Verboom L et al. PubMed ID 19567604
Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis. 1990 Jan;141(1):68-71. Leech JA et al. PubMed ID 2297189
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NATIONAL COELIAC ASSOCIATION
Low bone mass is common amongst people with coeliac disease (CD)1. The major causes of osteoporosis include malabsorption of calcium, vitamin D, protein and other nutrients, and the accompanying weight deficit. A large UK study found that people with CD were almost twice as likely to break their hip as compared to people without the disease2.
In 2016, investigators from the United States evaluated adherence to osteoporosis screening guidelines among people with CD3. After a diagnosis of CD had been made, approximately one third of patients underwent bone mineral density (BMD) testing. However, only in about half of these cases was the BMD test done specifically because of the CD diagnosis. However, therapeutic intervention occurred for the majority (75%) of those that had a BMD test done.
The following strategies can help people with CD to maintain healthy bones:
1 2 3
Follow a strict gluten-free diet that is rich in calcium and vitamin D: Calcium is contained in various foods, and especially in dairy products. Vitamin D is produced in the skin upon exposure to sunlight. Although some people are able to obtain enough vitamin D naturally via sunlight, older people are often deficient in this vitamin due, in part, to limited time spent outdoors. They may require vitamin D supplements to ensure an adequate daily intake. In 2014, the British Society of Gastroenterology published guidance which recommended that adults with CD have a daily intake of at least 1,000 mg of calcium4.
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Regular bone strengthening exercise: Regular weight-bearing and muscle-strengthening exercise can also help prevent bone loss and, by enhancing balance and flexibility, reduce the likelihood of falling and breaking a bone.
Maintain a healthy lifestyle: Avoiding smoking and excessive alcohol intake, while maintaining a healthy body weight, is important for bone health.
Minimise the risk of falling: Two main steps to avoiding falls is wearing slip-proof shoes and fall-proofing the home. The latter may include installing hand rails on stairs and in bathrooms as well as ensuring that walkways are free of hazards (such as loose rugs).
References:Celiac disease is associated with reduced bone mineral density and increased FRAX scores in the US National Health and Nutrition Examination Survey. Osteoporos Int. 2017 Mar;28(3): 781-790. Kamycheva E et al. PubMed ID 27714440
Fracture risk in people with celiac disease: a population-based cohort study. Gastroenterology. 2003 Aug;125(2):429-36. West J et al. PubMed ID 12891545
Implementation and adherence to osteoporosis screening guidelines among coeliac disease patients. Dig Liver Dis. 2016 Dec;48(12):1451-1456. Singh P et al. PubMed ID 27665261
Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014 Aug;63(8):1210-28. Ludvigsson JF et al. PubMed ID 24917550
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NATIONAL DIABETES ASSOCIATION
Bone health is compromised in people who are living with diabetes. The relationship between diabe-tes and osteoporosis is complex, and the subject of much scientific and clinical research throughout the world1. Studies have shown that people with both type 1 and type 2 diabetes are at increased risk of suffering fragility fractures. As compared to individuals without diabetes, people with type 1 and type 2 diabetes are up to 6.3 times and 1.7 times more likely to break their hip, respectively2.
In 2016, a comprehensive review on bone health in type 2 diabetes concluded3:
1 2 3
Despite often having normal to high bone mineral density (BMD), individuals with type 2 diabetes have increased fracture risk irrespective of sex, race or ethnicity. Accordingly, BMD measurements may underestimate skeletal fragility in type 2 diabetics.
There is little data available on the optimum management of osteoporosis in type 2 diabetes.
In the absence of evidence to the contrary, management should adhere to the established principles of management of postmenopausal osteoporosis.
References:Mechanisms of diabetes mellitus-induced bone fragility. Nat Rev Endocrinol. 2017 Apr;13(4):208-219. Napoli N et al. PubMed ID 27658727
Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. Am J Epidemiol. 2007 Sep 1;166(5):495-505. Janghorbani M et al. PubMed ID 17575306
Type 2 diabetes and the skeleton: new insights into sweet bones. Lancet Diabetes Endocrinol. 2016 Feb;4(2):159-73. Bouxsein ML et al. PubMed ID 26365605
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NATIONAL HIV/AIDS ASSOCIATION
In 2016, Professor Juliet Compston of the University of Cambridge, UK wrote1:
1
“The success of antiretroviral therapy in treating HIV infection has greatly prolonged life expectancy in affected individuals, transforming the disease into a chronic condition.”
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References:
References:
Consequently, a number of diseases including osteoporosis are becoming increasingly significant among older individuals with HIV. In addition to risk factors evident in the general population, people living with HIV may have specific HIV-related risk factors for osteoporosis, including anti-retroviral therapy (ART), chronic inflammation, co-infection with hepatitis C or hepatitis B, kidney disease and diabetes.
Clinical guidelines from Europe2 and the United States3 recommend that individuals with HIV aged 40 years and over should undergo fracture risk assessment with the FRAX® algorithm4. In women and men aged 50 years and over, bone mineral density (BMD) should be measured if clinical risk factors are present and/or if indicated by the probability of fracture derived by FRAX®. Individuals who have lost more than 4 cm in height, have developed a kyphosis (i.e. a forward rounding of the back) or who have low BMD should also undergo imaging of the spine to identify vertebral fractures. All older people who are living with HIV should receive advice on lifestyle measures to optimise bone health. Those deemed to be at high fracture risk should be considered for treatment with bisphosphonate therapies.
References:HIV infection and bone disease. J Intern Med. 2016 Oct;280(4):350-8. Compston J. PubMed ID 27272530
European AIDS Clinical Society Guidelines version 8.2. January 2017. Accessible from http://www.eacsociety.org/guidelines/eacs-guidelines/eacs-guidelines.html.
Recommendations for evaluation and management of bone disease in HIV. Clin Infect Dis. 2015 Apr 15;60(8):1242-51. Brown TT et al. PubMed ID 25609682
FRAX® Fracture Risk Assessment Tool. University of Sheffield. Accessible from: https://www.sheffield.ac.uk/FRAX/.
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NATIONAL PROSTATE CANCER ASSOCIATION
Approximately half of men diagnosed with prostate cancer will receive androgen deprivation therapy (ADT) at some stage after diagnosis1. A rapid decline in bone mineral density (BMD) is observed during the first year of ADT treatment2. Investigators from the United States reported that men treated with ADT, in the form of gonadotropin-releasing hormone agonists (GnRHs), had higher fracture rates than a comparison group who did not receive GnRH agonist treatment3. The rate of vertebral fractures and hip/femur fractures were 50% and 30% higher, respectively.
Despite clinical guidelines relating to the prevention and treatment of ADT-induced osteoporosis being available in several countries4-8, studies have reported care gaps in Canada9, India10 and the United States11. The rates of BMD testing and/or osteoporosis treatment varied considerably, with the majority of men not receiving appropriate care.
Guidelines for Australia and New Zealand provide an illustration of what best practice includes4:
1 2 3 4
Baseline assessment of bone health at the initiation of ADT.
General measures to prevent bone loss, including regular physical activity, as well as ensuring calcium and vitamin D sufficiency.
Men with a previous fragility fracture should receive osteoporosis treatment unless contraindicated; for those who have not sustained a fragility fracture, treatment is advised for men at high fracture risk.
References:Bone health management in men undergoing ADT: examining enablers and barriers to care. Osteoporos Int. 2015 Mar;26(3):951-9. Damji AN et al. PubMed ID 25526712
Bone loss following hypogonadism in men with prostate cancer treated with GnRH analogs. J Clin Endocrinol Metab. 2002 Aug;87(8):3656-61. Mittan D et al. PubMed ID 12161491
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Aromatase inhibitors (AIs) are the gold standard adjuvant treatment for postmenopausal women with hormone receptor-positive breast cancer1. Women taking AIs experience elevated rates of bone loss as compared to healthy postmenopausal women2. Studies comparing two commonly used AIs, anastrozole3 and letrozole4, with tamoxifen have reported significant increases in fracture risk for the AI treated patients.
Despite clinical guidelines relating to the prevention and treatment of AI-induced osteoporosis being available in several countries2,5-11, studies have reported care gaps in the UK12 and the United States13. In 2012, the European Society for Clinical and Economical Aspects of Osteoporosis (ESCEO) published guidance on prevention of bone loss and fractures in postmenopausal women treated with AIs2. Key recommendations included:
1 2 3 4
NATIONAL BREAST CANCER ASSOCIATION
Baseline assessment of bone health when AIs are initiated.
General measures to prevent bone loss, including regular physical activity, as well as ensuring calcium and vitamin D sufficiency.
Osteoporosis treatment should be offered to the following groups:
Women aged 75 years and over, irrespective of their bone mineral density status.
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Gonadotropin-releasing hormone agonists and fracture risk: a claims-based cohort study of men with nonmetastatic prostate cancer. J Clin Oncol. 2005 Nov 1;23(31):7897-903. Smith MR et al. PubMed ID 16258089
Bone and metabolic health in patients with non-metastatic prostate cancer who are receiving androgen deprivation therapy. Med J Aust. 2011 Mar 21;194(6):301-6. Grossmann M et al. PubMed ID 21426285
Management of cancer treatment-induced bone loss in early breast and prostate cancer -- a consensus paper of the Belgian Bone Club. Osteoporos Int. 2007 Nov;18(11):1439-50. Body JJ et al. PubMed ID 17690930
GU radiation oncologists consensus on bone loss from androgen deprivation. Can J Urol. 2006 Feb;13(1):2962-6. Duncan GG et al. PubMed ID 16515750
National Institute for Health and Care Excellence. NICE Clinical Guideline 175: Prostate cancer: diagnosis and management. London 2014. Accessible from:https://www.nice.org.uk/guidance/cg175.
NCCN Task Force Report: Bone Health In Cancer Care. J Natl Compr Canc Netw. 2013 Aug;11 Suppl 3:S1-50; quiz S51. Gralow JR et al. PubMed ID 23997241
Management of decreased bone mineral density in men starting androgen-deprivation therapy for prostate cancer. BJU Int. 2009 Mar;103(6):753-7. Panju AH et al. PubMed ID 19007370
Bone densitometric assessment and management of fracture risk in Indian men of prostate cancer on androgen deprivation therapy: Does practice pattern match the guidelines? Indian J Urol. 2012 Oct;28(4):399-404. Pradhan MR et al. PubMed ID 23450674
Osteoporosis management in prostate cancer patients treated with androgen deprivation therapy. J Gen Intern Med. 2007 Sep;22(9):1305-10. Yee EF et al. PubMed ID 17634780
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Postmenopausal women who have a history of fragility fracture or are deemed to be at high fracture risk on account of certain other risk factors.
References:Meta-analysis of breast cancer outcomes in adjuvant trials of aromatase inhibitors versus tamoxifen. J Clin Oncol. 2010 Jan 20;28(3):509-18. Dowsett M et al. PubMed ID 19949017
Guidance for the prevention of bone loss and fractures in postmenopausal women treated with aromatase inhibitors for breast cancer: an ESCEO position paper. Osteoporos Int. 2012 Nov;23(11):2567-76. Rizzoli R et al. PubMed ID 22270857
Effect of anastrozole and tamoxifen as adjuvant treatment for early-stage breast cancer: 10-year analysis of the
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References:
ATAC trial. Lancet Oncol. 2010 Dec;11(12):1135-41. Cuzick J et al. PubMed ID 21087898
Five years of letrozole compared with tamoxifen as initial adjuvant therapy for postmenopausal women with endocrine-responsive early breast cancer: update of study BIG 1-98. J Clin Oncol. 2007 Feb 10;25(5):486-92. Coates AS et al. PubMed ID 17200148
Management of cancer treatment-induced bone loss in early breast and prostate cancer -- a consensus paper of the Belgian Bone Club. Osteoporos Int. 2007 Nov;18(11):1439-50. Body JJ et al. PubMed ID 17690930
[Expert group consensus: prevention, diagnosis and treatment of bone loss and osteoporosis in postmenopau-sal breast cancer patients after aromatase inhibitor therapy]. [Article in Chinese]. Zhonghua Zhong Liu Za Zhi. 2013 Nov;35(11):876-9. Xiu Bing-He et al. PubMed ID 24447490
Dachverband Osteologie. DVO guideline 2009 for prevention, diagnosis and therapy of osteoporosis in adults 2014. Accessible from www.dv-osteologie.org/dvo_leitlinien/osteoporose-leitlinie-2014.
Italian association of clinical endocrinologists (AME) position statement: drug therapy of osteoporosis. J Endocrinol Invest. 2016 Jul;39(7):807-34. Vescini F et al. PubMed ID 26969462
Guidelines for diagnostics and treatment of aromatase inhibitor-induced bone loss in women with breast cancer: a consensus of Lithuanian medical oncologists, radiation oncologists, endocrinologists, and family medicine physicians. Medicina (Kaunas). 2014;50(4):197-203. Juozaityte E et al. PubMed ID 25458955
Guidance for the management of breast cancer treatment-induced bone loss: a consensus position statement from a UK Expert Group. Cancer Treat Rev. 2008;34 Suppl 1:S3-18. Reid DM et al. PubMed ID 18515009
NCCN Task Force Report: Bone Health In Cancer Care. J Natl Compr Canc Netw. 2013 Aug;11 Suppl 3:S1-50; quiz S51. Gralow JR et al. PubMed ID 23997241
Novel way to implement bone assessment guidelines to identify and manage patients receiving aromatase inhibitors using FITOS software. Osteoporos Int. 2007;18 (Suppl 3:S282-S283. Abstract P242A. Dolan AL et al. PubMed ID 17963017
Bone mineral density screening among women with a history of breast cancer treated with aromatase inhibitors. J Womens Health (Larchmt). 2013 Feb;22(2):132-40. Spangler L et al. PubMed ID 23362883
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SENIOR’S ORGANISATIONS
Your national osteoporosis society marks World Osteoporosis Day on 20th October 2017
This month, our friends at your national osteoporosis society are supporting the International Osteoporosis Foundation’s (IOF) World Osteoporosis Day (WOD) Awareness Campaign. Under its theme of Love Your Bones: Protect Your Future, the WOD 2017 Campaign calls upon the general public to take early action to protect their bone and muscle health, and for health authorities and physicians to protect their communities’ bone health.
Osteoporosis is the most common bone disease. One in three women aged 50 years and over will sustain a fragility fracture, as will one in five men. Fragility fractures impose a tremendous burden on our older people, their families and carers, and our economy. A broad range of osteoporosis treatments, available in an array of dosing regiments, have been shown to significantly reduce the risk of hip fractures, vertebral fractures and other clinically apparent fractures.
In October, the International Osteoporosis Foundation (IOF) will publish the first IOF Compendium of Osteoporosis, which will be updated frequently. The IOF Compendium provides:
A summary of current knowledge of bone biology and risk factors which pre-dispose individuals to suffer fragility fractures, the clinically significant consequence of osteoporosis.
Preventive strategies, including the role of nutrition and exercise in maintaining bone health throughout life is considered.
Updates on new osteoporosis treatments, models of care which efficiently target treatments to individuals at high fracture risk, and the global and regional burden of osteoporosis.
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Your national osteoporosis society, IOF and [insert the Seniors organisation’s name] describe the overarching objectives for good bone health at the various stages of life as:
Children and adolescents: Achieve genetic potential for peak bone mass.
Adults: Avoid premature bone loss and maintain a healthy skeleton.
Seniors: Prevent and treat osteoporosis.
The following groups should be prioritised for osteoporosis assessment and receive guidelines-based treatment:
Individuals who have sustained a fragility fracture since their 50th birthday.
People being treated with commonly used medicines which have an adverse effect on bone health (e.g. glucocorticoids, androgen deprivation therapy and aromatase inhibitors).
The [insert Seniors organisation name] commends your national osteoporosis society for their efforts to improve awareness of osteoporosis.
If you would like to learn more visit www.worldosteoporosisday.org and check out your national osteoporosis society’s website too.
A Blueprint for Action provides all stakeholders with clear recommendations for achieving optimal bone health for all.
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WEB CONTENT
The articles provided in the previous section could serve as copy for web content, either in their current form or abridged.
SOCIAL MEDIA POSTS
The following generic social media post could be used by all organisations.
Love Your Bones: Protect Your Future
This month, our friends at your national osteoporosis society are supporting the International Osteoporosis Foundation’s World Osteoporosis Day (WOD) Awareness Campaign.
Under its theme of Love Your Bones: Protect Your Future, WOD 2017 calls upon the general public to take early action to protect their bone and muscle health, and for health authorities and physicians to protect their communities’ bone health.
If you would like to learn more visit www.worldosteoporosisday.org and check out your national osteoporosis society’s website too.
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International Osteoporosis Foundation9 rue Juste-Olivier • CH-1260 Nyon • Switzerland •
T +41 22 994 01 00 • F +41 22 994 01 01 [email protected] • www.iofbonehealth.org
Our vision is a world without fragility fractures, in which healthy mobility is a reality for all.
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