Bone health is a crucial part of everyone’s overall well-being, and Amgen Canada has long encouraged Canadians and their healthcare providers to adopt a proactive outlook to osteoporosis prevention.
Unfortunately, that’s become more of a challenge during the COVID-19 pandemic, which has caused interruption in routine and preventive health care services1. The International Osteoporosis Foundation (IOF) warns that many patients have delayed healthcare visits to their doctor, including scheduled and routine visits that would have included discussions and assessments regarding bone density and osteoporosis screening2.
At Amgen we’re concerned about any setback for bone health, and we hope stakeholders and patients across Canada will take notice, too.
‘Concerning’ data for osteoporosis screening and treatment
This isn’t just a Canadian issue. Two recent studies have produced evidence that some aspects of screening and treatment for osteoporosis have taken a back seat during the pandemic for patients on every continent.
In the first article, published in Osteoporosis International3, researchers noted a dramatic falloff in the number of times people accessed the online FRAX fracture risk assessment tool around the world. The falloff coincided with the first wave of the pandemic in many countries.
The FRAX test is an online tool that allows a healthcare provider to walk a patient through a series of questions in order to determine their 10-year risk of an osteoporotic fracture or hip fracture4. (You can read more here about the severity of fragility fractures, and therefore why taking a FRAX test is a wise investment of a few minutes.)
According to the study, the number of FRAX sessions recorded was 58 per cent lower in April 2020(in other words, during the pandemic) than in February 20205(prior to the World Health Organization’s declaration of the pandemic on March 11, 20206). The authors infer that osteoporosis assessment was interrupted during this period for many patients as a result of COVID-19.7
For Canada, the falloff was lower than average, but still worrisome, at roughly 45 per cent8.
The second recent study9 into osteoporosis treatment during the pandemic provides evidence that interruptions in healthcare services and disease management have been experienced as a result of the situation.
Also published in Osteoporosis International, this research involved a global survey of healthcare professionals. It showed that interruptions of screening and care for osteoporosis is a concern around the world. Healthcare providers treating osteoporosis in 53 countries told researchers that during the pandemic they had experienced an interrupted supply of medications, reductions in parenteral (non-oral) medication delivery, and a reduction of bone-density scanning via dual-energy x-ray absorptiometry (DXA).10
Referring to the decline in DXA scans, the authors wrote: “Data from our survey are concerning and suggest that the traditional gold standard assessment11 [for] osteoporosis patients was not performed in the majority of cases during the pandemic.”
Yet it’s not clear that there’s any reason that DXA scans and other procedures should continue to be delayed. “Despite an understandable reticence of patients to attend in-person appointments,” the authors write, “approximately half of healthcare providers believed that there were sufficient safeguards in place to mitigate risk and allow in-person visits.”12
Osteoporosis care during COVID-19
While many patients have avoided medical appointments during the pandemic, seeing the doctor is just as important as ever. That includes visits relating to osteoporosis.
As per the International Osteoporosis Foundation, the world’s largest non-governmental organization dedicated to the prevention, diagnosis and treatment of osteoporosis,13 staying fracture-free is critical for anyone with osteoporosis, especially now with increased strain on the capacities of healthcare systems due to the pandemic.14
“We would also like to reassure people with osteoporosis, and those taking medications to treat osteoporosis, that having osteoporosis does not increase your risk of either contracting coronavirus or having serious complications15,” the IOF urged patients.
Where patient hesitancy or other barriers still exist, telemedicine offers one possible (and partial) remedy. As the study authors note, doctors and other healthcare professionals have seen more patients at a distance since the advent of COVID-1916— and may even continue to do so as the pandemic subsides.
What’s clear is that screening for osteoporosis must get back on track as soon as possible, one way or another. Amgen Canada hopes that healthcare providers and stakeholders will take every opportunity to encourage patients to participate in appropriate osteoporosis ongoing care. Bone health is too important to put off until later.
1 Fuggle 2021 - How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey, page 2
2 Fuggle 2021 - How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey, page 2
3 McCloskey2021_Article_GlobalImpactOfCOVID-19, page 39
7 McCloskey2021_Article_GlobalImpactOfCOVID-19, page 39
8 McCloskey2021_Article_GlobalImpactOfCOVID-19, page 42
9 Fuggle 2021 - How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey
10 Fuggle 2021 - How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey, page 1
11 Fuggle 2021 - How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey, page 5
12 Fuggle 2021 - How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey, page 6
14 https://www.osteoporosis.foundation/news/covid-19-and-osteoporosis-20200325-0900, COVID-19 and Osteoporosis (bolded)
15 https://www.osteoporosis.foundation/news/covid-19-and-osteoporosis-20200325-0900, COVID-19 and Osteoporosis
16 Fuggle 2021 - How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey, page 1