Recommendations from EU Report*
The expert committee provides compelling evidence in their report that fractures caused by osteoporosis pose a major and growing threat to the health of elderly populations in Europe.
The European Commission and the governments of the 15 member states, especially policy makers and national politicians, should explicitly adopt osteoporosis prevention as a major health care target and establish awareness campaigns. Prevention of osteoporosis should be a major priority in the ongoing health promotion, education and training of health care professionals.
Although some data are currently available, more information is required about the occurrence of osteoporotic fractures in different countries. This can be used to determine various causes of osteoporosis, assess potential preventive strategies, and to estimate cost involved in preventing and treating osteoporosis.
Establish co-ordinated systems for monitoring fracture rates at both national and European Community levels.
The number of osteoporotic fractures occurring over the next few decades in EU member states will rise dramatically.
Ensure that national systems are co-ordinated throughout the EU to plan effectively for the resulting increase in demands on health care and to institute appropriate resource reallocation.
Nutrition plays an important role in bone health. Dietary calcium intakes in many people fall below recommended levels and vitamin D deficiency is common, particularly in older people.
Develop, where appropriate, integrate and implement policies to advise the general public and health professionals about calcium and vitamin D nutrition, at all stages of life.
Bone density measurements provide the best approach for diagnosing osteoporosis but the current consensus among experts is that population-based screening cannot be justified and selection of patients for bone densitometry should be based on strong clincial risk factors. Access to and resources for these measurements in the EU member states are inadequate. Reimbursement is absent or partial in many member states.
Make bone density measurements accessible and reimbursable for high risk individuals.
Effective medicines are available for the prevention and treatment of osteoporosis and others are being developed, but so far an appropriately harmonised treatment strategy (including non pharmacological and pharmacological interventions) has not been established in the European Community.
Develop and co-ordinate guidelines on criteria for standard treatment strategies. Reimbursement should be available for approved treatments.
The important role of national patient and scientific societies is increasingly recognised. However, ignorance about osteoporosis is still common both amongst health professionals and the public.
Promote national patient and scientific societies by providing financial support and helping them to publicise their cause throughout the European Community.
Further research is urgently required in a number of areas including the effects of exercise, calcium and vitamin D on bone mass, prediction of fracture risk, osteoporosis screening, and causes and treatment of osteoporosis in men.
Fund further research in key areas in order to devise and implement better preventive strategies for osteoporosis.
Source: "Summary Report on Osteoporosis in the European Community Action for Prevention", © European Communities/European Foundation for Osteoporosis (EFFO now IOF), 1998.