Strategies for Better Identification and Management of Osteoporosis, with E. Michael Lewiecki, MD

There are significant barriers contributing to a large osteoporosis treatment gap, with the foremost important barrier being most high-risk patients are not being identified. Screening for osteoporosis is often neglected, and even when fractures occur, they are not always attributed to osteoporosis. Consequently, most patients with fractures, including hip fractures, do not receive an osteoporosis diagnosis or subsequent evaluation and treatment to reduce future fracture risk. Additionally, adherence to osteoporosis treatment is poor, with many patients not taking medication long enough to benefit.

In an interview with HCPLive, E. Michael Lewiecki, MD, director of New Mexico Clinical Research & Osteoporosis Center, discusses his 2024 CCR East presentation regarding the significant treatment gap in osteoporosis and barriers to care.

This gap in treatment is so severe that it has been deemed a crisis in osteoporosis care, prompting calls to action within the healthcare community to improve identification and treatment of high-risk patients. Unfortunately, progress in this area remains slow.

One promising approach, Lewiecki explained, is the Fracture Liaison Service (FLS), a systematic method for identifying patients with fractures, usually in a hospital setting. FLS coordinators, often nurse practitioners or physician assistants, track these patients post-discharge to ensure they receive the necessary evaluation and treatment to reduce future fracture risk.

Another effective strategy is the Bone Health ECHO (Extension for Community Healthcare Outcomes) program. This virtual community connects healthcare professionals worldwide through Zoom meetings, allowing them to present cases, discuss them, and learn how to better manage osteoporosis. This program supports both osteoporosis experts and beginners, helping local physicians become proficient in osteoporosis care. Since its inception at the University of New Mexico in 2015, 19 Bone Health ECHO programs have been established internationally, offering education in various time zones and languages.

Regarding osteoporosis treatment, Lewiecki believes any treatment is better than none, but some treatments are more effective than others. Fracture risk stratification is crucial, especially in health insurance contexts where step therapy requires starting with the cheapest drug.

Disclosures: Lewiecki has no disclosures to report.