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To screen or not to screen for osteoporosis amongst post-menopausal women with one prior osteoporotic fracture in Greece

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Abstract

Background

Screening and linkage to care (SLTC) for osteoporosis is suboptimal in several settings. In Greece, it is estimated that only up to 8.6% of postmenopausal women are SLTC for osteoporosis, despite having suffered a previous fracture.

Aims

This study aims to estimate the impact of comprehensive screening on future fracture burden amongst post-menopausal women aged 50–74, with one prior osteoporotic fracture, in Greece.

Methods

We developed a cohort stochastic model, based on published epidemiological and clinical data, to assess impact of screening on future fracture burden in two scenarios: a current, assuming an 8.6% background SLTC, and a completely hypothetical, assuming 100% SLTC.

Results

Amongst a cohort of 50,000 post-menopausal women aged 50–74, with one prior osteoporotic fracture, applying the hypothetical versus the current scenario would result in a reduction in deaths (–0.6%) and fractures (–4.3%) over 10 years. The hypothetical scenario leads to greater reductions in costs associated with vertebral (–8.1%) and hip (–5.5%) fractures, followed by other non-vertebral (–3.0%) and forearm (–2.5%) fractures. In the hypothetical scenario, treatment initiations and total screenings increased almost tenfold versus the current scenario, at an estimated direct incremental cost of 27.83€ per woman per year in the cohort.

Discussion

Our study adds to the existing evidence on the impact of screening to prevent fractures amongst post-menopausal women. Despite being based on a stochastic model, our study confirms findings most recently published in the literature.

Conclusions

Our study models the positive public health impact of increasing SLTC levels amongst post-menopausal women with a prior osteoporotic fracture.

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Data availability

The dataset used and analysed during the current study is available from the corresponding author on reasonable request.

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Funding

This work was supported by an unrestricted research grant from UCB/AMGEN. The funding body had no role in the design of the study, data collection and analysis, interpretation of the data and in writing the manuscript. UCB/AMGEN,4400428049.

Author information

Authors and Affiliations

  1. Department of Social and Education Policy, University of Peloponnese, Corinth, Greece

    Kyriakos Souliotis

  2. The Health Policy Institute, Maroussi, Greece

    Kyriakos Souliotis, Christina Golna, Paul Golnas & Ioannis-Anestis Markakis

  3. Department of Endocrinology and Diabetes and Department of Medical Research, 251 Hellenic Air Force and VA General Hospital, Athens, Greece

    Polyzois Makras

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  1. Kyriakos Souliotis
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  2. Christina Golna
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Contributions

SK: conception of the study; design of the study; acquisition of data; analysis and data interpretation; drafted the article, final approval of the version to be published. GC: conception of the study; design of the study; analysis and data interpretation; drafted the article, final approval of the version to be published. GP: analysis and data interpretation; drafting the article, final approval of the version to be published MI: analysis and data interpretation; drafting the article, final approval of the version to be published. MP: conception of the study; critically revising the article for intellectual content, final approval of the version to be published. The contributions above have been confirmed by the corresponding author on behalf of all authors. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Kyriakos Souliotis.

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Conflict of interest

The authors declare no other conflict of interest relative to this work. Souliotis K has received advisory boards’ fees from Boehringer Ingelheim, Βristol Myers Squibb and Pfizer. Makras P has received lecture fees/advisory boards from Amgen, ELPEN, Farmaserv, Galenica, Genesis, Lilly, Pfizer, Rapharm, Takeda, UCB Pharma, UniPharma, and VIANEX; research grant from Amgen.

Ethics approval and consent to participate

This is a modelling study and did not acquire nor use or store any patient data. Ethics committee approval and consent were not required.

Statement of human and animal rights

Our study is a stochastic modelling study and did not involve any human or animal participants. The study did not acquire nor use or store any human or animal data.

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Souliotis, K., Golna, C., Golnas, P. et al. To screen or not to screen for osteoporosis amongst post-menopausal women with one prior osteoporotic fracture in Greece. Aging Clin Exp Res 34, 2473–2481 (2022). https://doi.org/10.1007/s40520-022-02183-z

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  • DOI: https://doi.org/10.1007/s40520-022-02183-z

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