The International Osteoporosis Foundation (IOF) has published a new report looking at the burden and management of fragility fractures in six European countries (France, Germany, Italy, Spain, Sweden, UK) that highlights the hidden but very real burden of fragility fractures.

The International Osteoporosis Foundation (IOF) has published a new report called Broken bones, broken lives: A roadmap to solve the fragility fracture crisis in Europe. It provides new evidence that the clinical, societal, and cost burden associated with fragility fractures across the EU nations remains a growing public health concern requiring urgent action.

The report, which is supported by the National Osteoporosis Society, says that as the population is slowly ageing, preserving the independence and active lifestyles of the ageing population has become a multifaceted challenge that technology, social initiatives, and healthcare policy can help tackle.

This ageing population is set to continually rise to an estimated 24% in 2047 meaning the prevalence of chronic conditions such as osteoporosis will further increase, leading to an exponential rise in the incidence of fragility fractures.

With 2.68 million new broken bones every year in the EU, fragility fractures are a major obstacle to healthy ageing, impacting the independence and quality of life of 20 million women and men living with osteoporosis.

It added that fragility fractures can be avoided, but their prevention and management have long been neglected despite the massive associated costs on healthcare systems (€37.5 billion). It estimates that the NHS faces an annual burden of £4.5 billion in healthcare costs associated with these breaks, a sum which is threatening to cripple the British healthcare system by stealth.

Fragility fracture costs exceed those of many other chronic diseases (eg. chronic obstructive pulmonary disease [COPD], rheumatoid arthritis, hypertension).

All stakeholders involved in the development and implementation of initiatives to improve the prevention and management of fragility fractures, according to the IOF, have a role to play in protecting patients from further fractures and there is a need to up-scale the response to the silent threat of fragility fractures.

NOS Clinical Director Alison Doyle said: “There is significant impact on people’s lives. With over half a million new broken bones occurring in the UK. Without a commitment to change, people will continue to break their bones. This number is expected to increase by a further 26% by 2030. As well as the individual personal cost there is the associated cost impact escalating further, estimated to hit £5.9 billion in the same time period. The burden of fragility fractures in the UK already exceeds that for chronic obstructive pulmonary disease (COPD) and ischaemic stroke.

“Our beneficiaries tell us what is important to them, which is living well and embracing older age without the fear of further fractures.”

In addition to the cost burden, the physical and emotional impact must not be overlooked. Professor John Kanis, IOF Honorary President, said that fragility fractures can result in significant impairment, often making daily activities such as eating, dressing, washing or shopping difficult. For those who suffer a hip fracture, there is a 40% chance that they will not be able to walk independently. He said: “The physical and psychological impact is huge.”

Coordinated care models such as the Fracture Liaison Service (FLS) have shown to deliver improved patient outcomes and cost-saving treatments in an effective manner. In the UK, FLS provision cover is estimated to prevent 5,686 subsequent fragility fractures every year and achieve net cost savings of £1.2 million a year.

According to the NOS, additional solutions could help prevent many broken bones such as influencing through interactions with policy makers and commissioners. This will play a crucial role in funding diagnostic services and cost-effective interventions such as pharmacological treatment, falls prevention programs and coordinated care models, as well as enforcing necessary standards for healthcare professionals and institutions.

Professor Cyrus Cooper, IOF President, said: “With the rising burden of fragility fractures imposing on the NHS, it is our ambition that these reports can support stakeholders in taking the necessary actions to cut associated costs and stop broken bones from breaking lives.”

Alison Bloomer

Managing editor, GM