O Gómez1, A P Talero2, M B Zanchetta3, M Madeira4, C A Moreira5, C Campusano6, A M Orjuela7, S Cerdas P8,9, M P de la Peña-Rodríguez10, A A Reza11, C Velazco12, B Mendoza13, L R Uzcátegui14, P N Rueda15. 1. Departamento de Ciencias Fisiológicas, Facultad de Medicina de la Pontificia, Universidad Javeriana, Bogotá, Colombia. osgomezc@gmail.com. 2. Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACE), Bogotá, Colombia. 3. Cátedra de Osteología y Metabolismo Mineral, Facultad de Medicina, Universidad del Salvador, Instituto de Investigaciones Metabólicas (IDIM), Asociación Argentina de Osteología y Metabolismo Mineral (AAOMM), Sociedad Argentina de Endocrinología (SAEM), Buenos Aires, Argentina. 4. Departamento de Metabolismo Óseo y Mineral de La Sociedad Brasilera de Endocrinología y Metabolismo (SBEM), Universidade Federal Do Rio de Janeiro (UFRJ), Río de Janeiro, Brazil. 5. Servicio de Endocrinología del Hospital de Clínicas da UFPR (SEMPR), Departamento de Metabolismo Óseo y Mineral de la Sociedad Brasilera de Endocrinología y Metabolismo (SBEM), Universidade Federal Do Paraná (UFPR), Curitiba, Brazil. 6. Facultad de Medicina de la Universidad de los Andes, Unidad de Endocrinología de la Clínica Universidad de los Andes, Sociedad Chilena de Endocrinología y Diabetes (SOCHED), Santiago, Chile. 7. Facultad de Medicina de la Fundación Universitaria de Ciencias de la Salud (FUCS), Servicio de Endocrinología del Hospital San José, Asociación Colombiana de Osteoporosis y Metabolismo Mineral (ACOMM), Asociación Colombiana de Endocrinología (ACE), Bogotá, Colombia. 8. Facultad de Medicina de la Universidad de Costa Rica, Servicio de Endocrinología del Hospital Cima, Asociación Pro Estudio de la Diabetes, Endocrinología y Metabolismo (ANPEDEM), San José, Costa Rica. 9. Departamento de Endocrinología de la Facultad de Medicina de la Universidad Autónoma de Guadalajara (UAG), Servicios Médicos De la Peña, SC, Sociedad Mexicana de Nutrición y Endocrinología, Asociación Mexicana de Metabolismo Óseo y Mineral. Colegio Jalisciense de Endocrinología y Nutrición. Presidenta electa para la Asociación Mexicana de Metabolismo Óseo y Mineral, AC (AMMOM), Guadalajara, México. 10. Universidad Nacional Autónoma de México, sede Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Endocrinología y Metabolismo del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Sociedad Mexicana de Nutrición y Endocrinología y Consejo Mexicano de Endocrinología, Ciudad de México, México. 11. Instituto de Endocrinología, Nutrición y Osteoporosis, Fundación Dominicana de Enfermedades Metabólicas, Menopausia y Osteoporosis (FUNDEMOS), Santo Domingo, República Dominicana. 12. Clínica de Endocrinología y Metabolismo de la Facultad de Medicina de la República Oriental del Uruguay, Clínica de Endocrinología y Metabolismo del Hospital Manuel Quintela, Sociedad Uruguaya de Endocrinología y Metabolismo (SUEM), Montevideo, Uruguay. 13. Universidad de Los Andes, Sociedad Venezolana de Endocrinología y Metabolismo, Mérida, Venezuela. 14. Universidad Nacional de Colombia, Asociación Colombiana de Endocrinología, diabetes y metabolismo (ACE), Presidente de la Federación Latinoamericana de Endocrinología (FELAEN), Bogotá, Colombia. 15. Presidente de la Federación Latinoamericana de Endocrinología (FELAEN), Universidad Nacional de Colombia, Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACE), Bogotá, Colombia.
Abstract
The Latin American Federation of Endocrinology position statement on osteoporosis was developed by endocrinologists from 9 countries. It encompasses the definition, diagnosis, treatment, and follow-up of the disease, the identification of barriers to healthcare, and proposals to improve the disease care in the region. INTRODUCTION: There is a gap in the understanding of osteoporosis in Latin America. The objective of this work is to state the position of the Latin American Federation of Endocrinology on osteoporosis care in postmenopausal women to better bridge this gap. METHODS: An experts' panel was formed comprising of 11 endocrinologists from 9 countries. A data search was conducted with a conceptual approach and data selection was based on the hierarchy of the EBHC pyramid. Unpublished data was considered for local epidemiological data and expert opinion for the identification of barriers to healthcare. An expert consensus based on the Delphi methodology was carried out. Experts were asked to respond on a 5-point Likert Scale to two provided answers to guiding questions. RESULTS: Consensus was agreed on the answer for the questions with the higher median on the Likert scale and synthetized on 16 statements covering the definition of osteoporosis, diagnostic approach, treatment options, and follow-up. Besides clinical topics, unmet needs in osteoporosis were identified in relation to local epidemiological data, barriers to treatment, and misclassification of programs within health systems. CONCLUSIONS: Through a process based on recognized methodological tools, FELAEN's position on osteoporosis was developed. This made it possible to state an optimum scenario for the care of the disease and helped to identify knowledge gaps. There is great variability in the approach to osteoporosis in Latin America and barriers in all the stages of healthcare persist.
The Latin American Federation of Endocrinology position statement on osteoporosis was developed by endocrinologists from 9 countries. It encompasses the definition, diagnosis, treatment, and follow-up of the disease, the identification of barriers to healthcare, and proposals to improve the disease care in the region. INTRODUCTION: There is a gap in the understanding of osteoporosis in Latin America. The objective of this work is to state the position of the Latin American Federation of Endocrinology on osteoporosis care in postmenopausal women to better bridge this gap. METHODS: An experts' panel was formed comprising of 11 endocrinologists from 9 countries. A data search was conducted with a conceptual approach and data selection was based on the hierarchy of the EBHC pyramid. Unpublished data was considered for local epidemiological data and expert opinion for the identification of barriers to healthcare. An expert consensus based on the Delphi methodology was carried out. Experts were asked to respond on a 5-point Likert Scale to two provided answers to guiding questions. RESULTS: Consensus was agreed on the answer for the questions with the higher median on the Likert scale and synthetized on 16 statements covering the definition of osteoporosis, diagnostic approach, treatment options, and follow-up. Besides clinical topics, unmet needs in osteoporosis were identified in relation to local epidemiological data, barriers to treatment, and misclassification of programs within health systems. CONCLUSIONS: Through a process based on recognized methodological tools, FELAEN's position on osteoporosis was developed. This made it possible to state an optimum scenario for the care of the disease and helped to identify knowledge gaps. There is great variability in the approach to osteoporosis in Latin America and barriers in all the stages of healthcare persist.
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