In the coming decades, there will be tremendous increase in the number of people living with osteoporosis and suffering from harmful effects of fragility fractures. A newly published narrative review in 'Osteoporosis International' considers the key global challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health and fracture prevention.

Referring to important studies, guidelines and audits, this review revealed existence of gaps in providing care and defined solutions that will be required to implement to focus on the growing burden of fragility fractures in the world's population. Co-author Professor Eugene McCloskey, Director of the MRC ARUK Centre for Integrated Research in Musculoskeletal Ageing, Metabolic Bone Centre, Northern General Hospital, Sheffield, UK., authors found four different challenging themes, linked to: (1) case finding and management of individuals at high risk of fracture; (2) awareness in public regarding osteoporosis and fragility fractures; (3) reimbursement and health system policy; and (4) epidemiology of fracture in the developing world. They stated that it is sad to say that, gaps clearly reflect that presently less priority is given to bone health and fracture prevention in healthcare policy."

Highly required improvement in implementation of systematic approaches to prevent secondary fractures. Strategies and models of care like Fracture Liaison Services, which improves identification and treatment of individuals who have already sustained a first fragility fracture, are shown to be highly effective.

Strong attention is needed towards identification and management of patients under medicinal treatment which showed negative affect on bone health, and improved management of bone health in diseased people having bone loss and related fragility fractures as a common comorbid condition.

Need to increase awareness regarding life-changing and life-threatening impact of fractures due to osteoporosis. Given the extremely high rates of non-adherence to medication, it is essential to provide more support to patients and their doctors to discuss properly about the risk-benefit ratio of osteoporosis treatment, osteoporosis is not given that much attention as compared to other chronic conditions. It’s very difficult to approach and reimburse diagnostic testing and treatment in various countries of the world.

Strong epidemiological data is still needed to quantify fracture incidence in this developing world. Need to give high priority to develop fracture prevention policies in Asian and Latin America regions, with rapidly ageing populations.

Professor Cyrus Cooper, Chair of the International Osteoporosis Foundation (IOF) Committee of Scientific Advisors, stated: "We cannot afford to ignore the current and growing burden that osteoporosis and fragility fractures impose upon societies around the world. As we now have the knowledge and tools needed to manage bone health optimally, I urge healthcare professionals, stakeholder organizations, and healthcare authorities to make a concerted effort to implement these tools. Prioritization of fragility fracture prevention must become a reality worldwide."