Keele scientist calls for change in how osteoporosis is diagnosed

A Keele University academic is part of a team of researchers who are calling for the World Health Organisation (WHO) to change its official definition of the weak bone condition osteoporosis in order to increase consistency of diagnosis internationally and to also increase the uptake of treatment.

Dr Zoe Paskins, a Senior Lecturer and Consultant Rheumatologist from Keele’s School of Primary, Community and Social Care is jointly funded by the National Institute for Health Research (NIHR) Clinician Scientist Award and the Royal Osteoporosis Society, and co-authored an editorial article outlining the call in the Journal of Age and Ageing. Dr Paskins and her co-authors Dr David Armstrong and Dr Terence Ong have also been supported by the Royal Osteoporosis Society Aspiring Leaders’ programme.

Osteoporosis is a condition of weak bones where an individual is more likely to break a bone after a minor trip or fall. It is estimated that these broken bones cost the UK £4.4 billion a year and can cause significant physical, psychological and social issues. Many fractures are preventable with osteoporosis drugs, but in recent years an ‘osteoporosis crisis’ has been described by leading academics in the field, characterised by poor treatment uptake and consequent high levels of preventable fracture.

Dr Paskins argues that many people with osteoporosis do not receive the treatment they need due to inconsistencies with how the condition is diagnosed around the world, which can cause confusion for both clinicians and patients. According to the WHO, osteoporosis is determined by looking at a patient's bone density using a bone density scan. However, many other factors can influence bone fragility and patients who present with these other risk factors may be prescribed osteoporotic drugs, in accordance with osteoporosis guidelines.

Dr Paskins said: "Currently, a large proportion of people who have osteoporotic broken bones and are recommended osteoporosis medicines do not actually meet the criteria to be diagnosed with the condition, which are based strictly on bone density scan results alone.

“This results in confusion for healthcare professionals and patients alike, and may mean people do not take the medicines that are recommended.

“We think it is time for the WHO to reconsider the definition of osteoporosis, which is now more than 25 years old. A new definition is needed to acknowledge that it is possible, in some circumstances, to give a clinical diagnosis of osteoporosis in those who have osteoporotic fractures. In our view this would help address current confusion and improve uptake of treatments."