D L Kendler1, J D Adachi2, J P Brown3, A G Juby4, C S Kovacs5, C Duperrouzel6, R K McTavish6, C Cameron6, L Slatkovska7, N Burke8. 1. The University of British Columbia, Vancouver, British Columbia, Canada. 2. McMaster University, Hamilton, Ontario, Canada. 3. Laval University, Quebec City, Quebec, Canada. 4. University of Alberta, Edmonton, Alberta, Canada. 5. Memorial University, St. John's, Newfoundland, Canada. 6. EVERSANA, Burlington, Ontario, Canada. 7. Amgen Inc., Mississauga, Ontario, Canada. 8. Amgen Inc., Mississauga, Ontario, Canada. nburke02@amgen.com.
Abstract
The scorecard evaluates the burden and management of osteoporosis in Canada and how care pathways differ across Canadian provinces. The results showed there are inequities in patients' access to diagnosis, treatment, and post-fracture care programs in Canada. Interventions are needed to close the osteoporosis treatment gap and minimize these inequities. INTRODUCTION: The purpose of this study was to develop a visual scorecard that assesses the burden of osteoporosis and its management within Canada and seven Canadian provinces. METHODS: We adapted the Scorecard for Osteoporosis in Europe (SCOPE) to score osteoporosis indicators for Canada and seven provinces (British Columbia, Alberta, Saskatchewan, Ontario, Quebec, New Brunswick, and Newfoundland). We obtained data from a comprehensive literature review and interviews with osteoporosis experts. We scored 20 elements across four domains: burden of disease, policy framework, service provision, and service uptake. Each element was scored as red, yellow, or green, indicating high, intermediate, or low risk, respectively. Elements with insufficient data were scored black. RESULTS: Canada performed well on several elements of osteoporosis care, including high uptake of risk assessment algorithms and minimal wait times for hip fracture surgery. However, there were no established fracture registries, and reporting on individuals with high fracture risk who remain untreated was limited. Furthermore, osteoporosis was not an official health priority in most provinces. Government-backed action plans and other osteoporosis initiatives were primarily confined to Ontario and Alberta. Several provinces (Saskatchewan, New Brunswick, Newfoundland) did not have any registered fracture liaison service (FLS) programs. Access to diagnosis and treatment was also inconsistent and reimbursement policies did not align with clinical guidelines. CONCLUSION: Government-backed action plans are needed to address provincial inequities in patients' access to diagnosis, treatment, and FLS programs in Canada. Further characterization of the treatment gap and the establishment of fracture registries are critical next steps in providing high-quality osteoporosis care.
The scorecard evaluates the burden and management of osteoporosis in Canada and how care pathways differ across Canadian provinces. The results showed there are inequities in patients' access to diagnosis, treatment, and post-fracture care programs in Canada. Interventions are needed to close the osteoporosis treatment gap and minimize these inequities. INTRODUCTION: The purpose of this study was to develop a visual scorecard that assesses the burden of osteoporosis and its management within Canada and seven Canadian provinces. METHODS: We adapted the Scorecard for Osteoporosis in Europe (SCOPE) to score osteoporosis indicators for Canada and seven provinces (British Columbia, Alberta, Saskatchewan, Ontario, Quebec, New Brunswick, and Newfoundland). We obtained data from a comprehensive literature review and interviews with osteoporosis experts. We scored 20 elements across four domains: burden of disease, policy framework, service provision, and service uptake. Each element was scored as red, yellow, or green, indicating high, intermediate, or low risk, respectively. Elements with insufficient data were scored black. RESULTS: Canada performed well on several elements of osteoporosis care, including high uptake of risk assessment algorithms and minimal wait times for hip fracture surgery. However, there were no established fracture registries, and reporting on individuals with high fracture risk who remain untreated was limited. Furthermore, osteoporosis was not an official health priority in most provinces. Government-backed action plans and other osteoporosis initiatives were primarily confined to Ontario and Alberta. Several provinces (Saskatchewan, New Brunswick, Newfoundland) did not have any registered fracture liaison service (FLS) programs. Access to diagnosis and treatment was also inconsistent and reimbursement policies did not align with clinical guidelines. CONCLUSION: Government-backed action plans are needed to address provincial inequities in patients' access to diagnosis, treatment, and FLS programs in Canada. Further characterization of the treatment gap and the establishment of fracture registries are critical next steps in providing high-quality osteoporosis care.
Authors: Alan Bell; David L Kendler; Aliya A Khan; Marla Shapiro C M; Anne Morisset; Jean-Pierre Leung; Maureen Reiner; Stephen M Colgan; Lubomira Slatkovska; Millicent Packalen Journal: Arch Osteoporos Date: 2022-05-06 Impact factor: 2.879
Authors: Caitlin McArthur; Ahreum Lee; Hajar Abu Alrob; Jonathan D Adachi; Lora Giangregorio; Lauren E Griffith; Suzanne Morin; Lehana Thabane; George Ioannidis; Justin Lee; William D Leslie; Alexandra Papaioannou Journal: Arch Osteoporos Date: 2022-02-04 Impact factor: 2.617
Authors: Ron Goeree; Natasha Burke; Manon Jobin; Jacques P Brown; Donna Lawrence; Björn Stollenwerk; Damon Willems; Ben Johnson Journal: Arch Osteoporos Date: 2022-04-26 Impact factor: 2.879
Authors: T Oliveira; J Brown; A G Juby; P Schneider; R J Wani; M Packalen; S Avcil; S Li; M Farris; E Graves; S McMullen; D L Kendler Journal: Arch Osteoporos Date: 2022-08-03 Impact factor: 2.879