APCO launches first pan-Asia Pacific clinical standards for osteoporosis

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

Published in International Osteoporosis today, the ‘APCO Framework’ includes 16 minimum clinical standards that are set as a benchmark for providing the best osteoporosis care in the region.

Developed by APCO members representing key stakeholders of osteoporosis, and medical and surgical multidisciplinary, this set of clear, concise, relevant and pragmatic clinical standards aims to support national associations, leading development authorities , and healthcare policy makers with the development of new guidelines, and to encourage the review of existing guidance.

According to the Framework’s lead author, APCO Chairman, and Director of the Osteoporosis and Bone Metabolism Unit at Singapore General Hospital, Dr Manju Chandran, Singapore, APCO used the 5IQ analysis and Delphi-based consensus process to analyze the 18 clinical practice guidelines currently available in the Asia Pacific region, to inform the development of the APCO Framework.

“Using Delphi’s holistic, quadripartite consensus approach has allowed our APCO members working in very diverse healthcare systems to reach a remarkable level of consensus on a set of rods. -measurement of clinical standards for the provision of quality osteoporosis care for the Asia Pacific region. “

The APCO Framework provides clinicians with structured, well-defined and easily accessible clinical practice guidelines that explain:

• Individuals to be identified for assessment;
• Searches 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 care provision; and
• The need for, and methods for, monitoring and improving the quality of osteoporosis care.

“The implementation of the APCO Framework, or a similar set of care standards to the Framework, is expected to reduce the burden of osteoporosis not only in the Asia Pacific region, but worldwide. We hope that the Framework can be a stimulus for harmonization of directions in other sectors with socioeconomic diversity and the diversity of healthcare facilities, “said Dr Chandran.

Globally, the population aged 65 and over increased from six per cent in 1990, to nine per cent in 2019. This proportion is expected to rise to 16 per cent by 2050.1 meaning one in six people worldwide will be aged 65 or over by 2050. The number of people aged 60 and over is expected to be in the Asia-Pacific region – home to more than a third of The world’s population aged 65 and over, and to more elderly people than any other region – tripled between 2010 and 2050, reaching a staggering 1.3 billion people.

Osteoporotic fractures among Asia-Pacific populations are expected to rise, abruptly, not only due to the region’s rapidly growing population, but also due to rising urbanization , and the subsequent rise in quiet lifestyles.

Despite the general presence of safe and effective treatments for osteoporosis, up to five out of six patients who present to their primary care physician (PCP), or to a hospital with a sensitivity fracture, will not be assessed for osteoporosis. , or appropriately managed to prevent further breakage.

According to the Medical Director of Osteoporosis Australia, and APCO Executive Committee member, Professor Peter Ebeling AO, Australia, as many as half of those who suffered a hip fracture, have previously had a fracture at other skeletal sites.

In fact, any site has a pre-existing breach associated with doubling the risk of future fracture and mortality. The unfortunate drawbacks of fully diagnosed and under-treated osteoporosis are that a large number of people continue to have more destructive secondary fractures, which puts a huge, but importantly, preventable burden on it. health care systems that are already under pressure. “

Patrick Ebeling, APCO Professor and Executive Committee Member, International Osteoporosis Foundation

Sensitivity breaches, which occur every three seconds worldwide, damage quality of life and loss of independence. Anxiously, one in four patients who sustain a hip fracture die within a year, and less than half of those who survive, regain their normal level of functioning before. In 2010, an estimated 158 million people aged 50 and over were at high risk for osteoporotic fractures – a figure that is set to double by 2040.

According to the Head of the International Osteoporosis Foundation (IOF) and APCO Executive Committee member Dr Philippe Halbout, Switzerland, these numbers are alarming, coupled with the expected disproportionate rise in osteoporotic fractures among Asia-Pacific numbers, guaranteeing a standard set of minimum clinical standards for the region.

“Reported evidence to date reveals a significant inconsistency in the direction of osteoporosis clinical practice in the Asia Pacific region, which is widely changing in scope and recommendations. This was confirmed when we analyzed the 18 directions. “

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