The Asia Pacific Consortium on Osteoporosis (APCO) has this week launched the first pan-Asia Pacific clinical practice standards for the screening, diagnosis and management of osteoporosis, targeting a broad range of high-risk groups.

Published in Osteoporosis International, ‘The APCO Framework’ contains 16 minimum clinical standards set to serve as a benchmark for the provision of quality osteoporosis care for the Asia Pacific region.

This clear and pragmatic set of clinical standards aim to support national societies, guidelines development authorities, and healthcare policymakers with the development of new guidelines, and to encourage the revision of existing guidelines.

According to the Framework lead author, APCO Chairperson, and Director of the Osteoporosis and Bone Metabolism Unit, Singapore General Hospital, Dr Manju Chandran, Singapore, “Implementation of The Framework, or a similar set of standards of care informed by The Framework, is expected to significantly reduce the burden of osteoporosis in the Asia Pacific region, and worldwide.

“We hope the Framework can serve as a stimulus for the harmonisation of guidelines in other regions that have similar socio-economic diversity and heterogeneity of health care resources,” said Dr Chandran.

The number of people aged 60 years and above in Asia Pacific – home to more than a third of the world’s population aged 65 years and over, and to more older people than any other region – is predicted to triple between 2010 and 2050, reaching a staggering 1.3 billion people. Osteoporotic fractures among Asia-Pacific populations are ancipated to significantly escalate, due to the region’s rapidly aging population, mounting urbanisation, and subsequent increase in sedentary lifestyles. Currently one-in-four patients who sustain a hip fracture die within a year, and less than half of those who survive, regain their previous level of function.

As many as half of those who have sustained a hip fracture, have already experienced a previous fracture at other skeletal sites.

“In fact, a prior fracture at any site is associated with a doubling of future fracture and mortality risk,” said APFFA Secretariat representative, APCO Executive Committee member and Adjunct Senior Lecturer, School of Medicine, University of Notre Dame Australia, Mr Paul Mitchell, New Zealand.

“The unfortunate ramifications of the gross under-diagnosis and under-treatment of osteoporosis is that a large number of people sustain further debilitating secondary fractures, which places a substantial, but importantly, preventable burden on already strained healthcare systems.

“While we’ve made good progress in bone health management in New Zealand, it’s crucial to continue the momentum here and ensure standards of care are being met across the whole Asia Pacific region,” Mr Mitchell said.

International Osteoporosis Foundation (IOF) CEO and APCO Executive Committee member, Dr Philippe Halbout, Switzerland, said a standardised set of minimum clinical standards is most warranted for the region.

“Anecdotal evidence to date reveals significant inconsistencies in osteoporosis clinical practice guidelines in the Asia Pacific region, which vary widely in scope and recommendations. This was confirmed when we analysed the 18 guidelines.

“Implementation of the minimum clinical standards proposed by The APCO Framework, and reform of existing guidelines, will support clinical improvement initiatives, while also paving the way for a more holistic approach to osteoporosis care, and ultimately, greater consistency across all national and regional clinical practice guidelines in the region,” Dr Halbout said.

The APCO Framework defines:

• Individuals to be identified for assessment;
• Investigations required;
• Relevant indications for treatment;
• Appropriate selection of interventions to be made;
• The guidance and information patients need for self-care;
• Integration of healthcare systems for optimal provision of care; and
• The need, and methods for monitoring and improving the quality of osteoporosis care.

To download The APCO Framework, head to apcobonehealth.org/apco-framework.

To learn more, watch the short video below.