Time to reframe osteoporosis: a position statement to characterize the osteoporosis care gap
Year: 2026
Type: article
Abstract: Osteoporosis, a condition marked by increased fracture risk, remains under-diagnosed and under-treated worldwide, resulting in a substantial “treatment gap”—the difference between those eligible for osteoporosis treatment and those who actually receive it. While the concept of closing the treatment gap is commendable, and has galvanized clinical and policy efforts, this position statement argues that the prevailing narrative is in danger of becoming disease-focused and parentalistic, neglecting person-centered care. An international consensus group, including public contributors with lived experience were convened to define and characterize the “osteoporosis care gap” as a broader framework, encompassing deficits not only in pharmacological treatment but also in diagnosis, assessment, and multi-disciplinary management. The care gap is thus defined as “the discrepancy between the care provided to those at risk of osteoporotic fractures and best practice, person-centered care.” Multi-level determinants of the care gap are identified including: societal—low public awareness underpinned by unhelpful stereotypes, and prevalent health inequalities; health policy—insufficient prioritization, diagnostic confusion, and lack of incentivization; healthcare service—fragmented care pathways with unclear roles and poor communication, inadequate follow-up, and insufficient support for shared decision making; and individual—unmet needs for care which is person-centered, participatory, understandable, equitable, holistic and multidisciplinary, and respects autonomy. The statement calls for a person-centered, equitable, and multidisciplinary approach to osteoporosis care, integrating the perspectives and needs of patients, families, and caregiver. Actions needed at societal and policy level are described, including increasing public awareness, increasing health policy prioritization, with clear professional leadership. The components of osteoporosis care are described in terms of case finding, assessment, treatment, and review. Addressing this, care gap requires coordinated efforts from policymakers, healthcare services, and professionals, with a renewed focus on equity and patient values and preferences.
Source: JBMR Plus
Authors: Zoe Paskins, Laurna Bullock, Ashley Hawarden, Fiona Blackman, David J Armstrong, Ida Bentley, Emma M Clark, Robin M Daly, Deborah David, Valerie Farr, Dan Flower, Celia L Gregson, Jill Griffin, Barbara Hauser, Muhammad Kassim Javaid, Clare Jinks, Rose Jones, Chelsea Kettle, Emily Lam, Sarah Leyland, Janice McKinley, Elaine Nicholls, Terence W O’Neill, Terence Ong Ing Wei, Opinder Sahota, Ken Poole, Stuart Ralston, Carmelinda Ruggiero, Kanta Sandhu, Caroline Sangan, Corinne Turnbull, Nic Vine
Institutions: Keele University, University Hospitals Birmingham NHS Foundation Trust, Altnagelvin Area Hospital, Western Health and Social Care Trust, University of Bristol, Deakin University, Royal Osteoporosis Society, University Hospitals Plymouth NHS Trust, Western General Hospital, University of Oxford, Manchester Academic Health Science Centre, University of Manchester, Manchester University NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, Centre for Epidemiology Versus Arthritis, University of Malaya, Nottingham University Hospitals NHS Trust, University of Cambridge, NIHR Cambridge Biomedical Research Centre, Institute of Genetics and Cancer, University of Edinburgh, University of Perugia
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,888
OpenAlex ID: W7125014237