Professor Jean-Yves Reginster

Professor of Epidemiology, Public Health and Health Economics, University of Liege, Belgium and IOF General Secretary

Not so long ago, campaigners had to fight to convince the medical community that osteoporosis deserved recognition as an important and widespread disease. Today, although understanding of the disease itself has increased, the successful management of osteoporosis is still under threat from another aspect of under-recognition.

Like many chronic diseases, the effective management of postmenopausal osteoporosis is restricted by the difficulties patients often experience in taking their medication over a long period of time. A ‘silent disease’, osteoporosis is also frequently under-diagnosed, meaning people often end up sustaining a fracture before their condition is recognised. Just identifying those in the earlier stages of osteoporosis and initiating treatment can be a challenge in itself. However, even if people are diagnosed and commence treatment, with almost half stopping their medication after only one year, all this initial effort goes to waste. Without regular treatment, patients are putting themselves at increased risk of fracture, which, in the worst cases, can lead to long-term hospitalisation or death.

It is not enough to simply recognise that adherence is an issue. Steps must be taken to arm physicians, patients, family members and carers with the information they need to help people stay on treatment. If we are to ensure that fracture rates - and the associated personal and social costs - do not increase still further, we need to be sure these patients are not overlooked. Otherwise, we may be neglecting the welfare of millions of people around the world.