More than 25 organizations between patient associations, scientific societies and professionals in the health field and trade unions, have joined and signed the Manifesto for the Prevention of Bone Fractures, where they claim the eight points on which to focus and that would substantially improve the context current.
Among the claims, the need to include the prevention of fragility bone fractures in health plans stands out. In addition, implement clinical practice guidelines to adequately follow up patients after a first fracture.
In addition, the manifesto calls for the establishment of a protocolized diagnostic fracture code agreed at the national level, for a correct detection and establishment of preventive treatment as well as its implementation at the level of primary care and hospitals, as is available with other pathologies like stroke.
Another measure to be implemented is to ensure coordinated action between specialist doctors, primary care, nursing and community pharmacy to facilitate the assessment and treatment of patients with bone fragility fractures. Therefore, the creation of fracture coordination units or Fracture Liaison Services (FLS) is another of the demands for the signatory entities. In addition, the text highlights as “vital” the promotion of information and the adherence of patients to treatment, as well as the need to have objective and scientific data.
In Spain, in 2017 , there were around 330,000 fragility fractures , with a healthcare cost of 4,200 million euros. According to forecasts, the cost per fragility fracture will grow more than 30% in 2030, so it could reach 5.5 billion . Despite the clinical, social, and economic burdens associated with fragility fractures and the availability of effective preventive treatments and specific clinical care alternatives for fragility fractures, 68% of women and 60% of men fractured people do not receive adequate assistance.
Secondary prevention of fragility fractures has long been neglected and has not been on the political agendas. For this reason, there is an urgent need to recognize this problem as a public health priority, establish strategies for the prevention of secondary fractures and allow society to have actions that allow healthy aging. The application of new preventive measures and early clinical diagnosis could save costs and prevent nearly 700,000 fractures.
Every 3 seconds a bone fragility fracture occurs in the world and the risk of suffering it increases in patients with a previous fracture between 2 and 5 times . It also triggers a spiral of health dependency and a clear decrease in quality of life. Unfortunately, the economic burden and the number of fragility fractures are increasing, however the measures that are being implemented to avoid them, such as prevention or health management and treatment strategies, have not increased at the same rate. It is a growing public health problem that currently affects 1 in 3 women and 1 in 5 men in Spain and an increase in cases is expected, due to its direct relationship with the aging population and the increase in hope. of life.
During the presentation of the manifesto, Jorge Hinojosa , manager of the General Patient Alliance ( AGP ), stated that “the current scenario demands that dialogue between all parties is key in solving health problems. This manifesto is a sample of it. We hope that the administration will be one more in the work for the prevention and treatment of bone fractures.
According to Mª Antonia Robles , President of AECOSAR “How could it be otherwise, we support the manifesto for the prevention of bone fractures, it seems terrible to us that in 2018 we still do not have the adequate procedures for prevention, diagnosis, assessment, intervention and follow-up of patients ”.
In this sense, explains Robles, “primary prevention is essential, we do not want to experience the fracture. We prefer an early diagnosis and the responsibility of the patient himself, supported by the necessary social health resources and the support of AECOSAR, which despite the great difficulties that this entails, is at his side to inform and guide him towards a better quality of life in addition to represent you in the claims before the Administration and the bodies responsible for promoting your health ”.
Dr. María Jesús Moro-Álvarez , vice president of the Spanish Society for Bone Research and Mineral Metabolism ( SEIOMM ), recalled that “in recent years a care model has been implemented in multidisciplinary Fracture Units (FLS, for its acronym in English). ). These units function as a multidisciplinary “single window” where patients with osteoporotic fractures are identified, treated and supported ”. In addition, he recalled that more and more hospitals are joining the fracture registry (REFRA), “which has the dual objective of obtaining epidemiological data on fragility fractures that occur in Spain and, prospectively, trying to improve the management of said fractures ”.
For his part, Juan Gómez, president of the Spanish Society of Rheumatology ( SER ) considers “key to support this manifesto”. In addition, he insisted that “this pathology should become a priority in public health, since fractures not only have a great impact on the functional capacity of the individual, but are also responsible for a high consumption of health resources. Hence, the need to implement strategies from public administrations that help to improve this problem ”.
