Singer Andrea J, Sharma Anita, Deignan Cynthia, Borgermans Liesbeth
Departments of Obstetrics and Gynecology and Medicine, MedStar Georgetown University Hospital, Washington, DC, USA.
Platinum Medical Centre, Brisbane, Australia.
Curr Med Res Opin. 2023 Mar;39(3):387-398. doi: 10.1080/03007995.2022.2141483. Epub 2023 Jan 24.
The World Health Organization issued a call to action for primary care to lead efforts in managing noncommunicable diseases, including osteoporosis. Although common, osteoporosis remains underdiagnosed and undertreated. Primary care practitioners (PCPs) are critical in identifying individuals at risk for osteoporosis and osteoporotic fractures; however, recent advances in assessment, diagnosis, and treatment of osteoporosis have not been incorporated into clinical practice in primary care due to numerous reasons including time constraints and insufficient knowledge. To close this gap in clinical practice, we believe PCPs need a practical strategy to facilitate osteoporosis assessment and management that is easy to implement.
In this article, we consolidate information from various global guidelines and highlight areas of agreement to create a streamlined osteoporosis management strategy for a global audience of PCPs.
We present a systematic approach to facilitate osteoporosis assessment and management that includes four steps: (1) identifying patients at risk through proactive screening strategies, (2) investigating and diagnosing patients, (3) intervening with personalized treatment plans, and (4) implementing patient-centered strategies for long-term management and monitoring of patients.
Primary care has a central role in ensuring the incorporation of key elements of holistic care as outlined by the World Health Organization in managing noncommunicable diseases including osteoporosis; namely, a people-centered approach, incorporation of specialist services, and multidisciplinary care. This approach is designed to strengthen the health system's response to the growing osteoporosis epidemic.
世界卫生组织发出行动呼吁，要求初级保健引领包括骨质疏松症在内的非传染性疾病管理工作。骨质疏松症虽常见，但仍存在诊断不足和治疗不充分的问题。初级保健从业者（PCP）在识别骨质疏松症及骨质疏松性骨折风险个体方面至关重要；然而，由于包括时间限制和知识不足在内的诸多原因，骨质疏松症评估、诊断和治疗方面的最新进展尚未纳入初级保健的临床实践。为弥合临床实践中的这一差距，我们认为PCP需要一种易于实施的实用策略来促进骨质疏松症的评估和管理。
在本文中，我们整合了各种全球指南中的信息，并突出共识领域，为全球PCP群体创建了一种简化的骨质疏松症管理策略。
我们提出了一种促进骨质疏松症评估和管理的系统方法，包括四个步骤：（1）通过主动筛查策略识别有风险的患者，（2）对患者进行调查和诊断，（3）采用个性化治疗方案进行干预，以及（4）实施以患者为中心的策略对患者进行长期管理和监测。
初级保健在确保将世界卫生组织概述的整体护理关键要素纳入包括骨质疏松症在内的非传染性疾病管理中起着核心作用；即以人为本的方法、专科服务的纳入以及多学科护理。这种方法旨在加强卫生系统对日益严重的骨质疏松症流行的应对。
