Improving fragility fractures throughout Asia Pacific

Regional Fragility Fracture Summit Asia-Pacific participants
The Asia Pacific Regional Fragility Fracture Summit, held in Singapore on May 27, 2018, united all key regional societies comprising clinicians who care for fracture patients. IOF showed its commitment to the establishment of a Regional Fragility Fracture Alliance that will focus on three key areas: improving acute care, the rehabilitation of fragility fracture patients, and secondary fracture prevention.

Asia Pacific – the world’s most populous region – is ageing rapidly.1

In 2016, the region’s 4.5 billion-strong population represented 60 per cent of the global population,1 more than 12 per cent of whom were aged 60 years or older1– a figure projected to exceed 25 per cent by 2050.1

Given more than half of the world’s hip fractures are anticipated to occur in Asia Pacific in 2050,2 concerted action is required to curtail this looming crisis. In recognition of such, and as part of their ongoing commitment to improving the lives of patients through the prevention of fragility fractures, Amgen Asia recently enabled two collaborative stakeholder initiatives – an Osteoporosis Regional Consortium and a Regional Fragility Fracture Summit – to help expedite policy change and quality improvement in fragility fractures caused by osteoporosis throughout Asia Pacific.

“On May 26, 2018, a group of leading clinicians from across Asia Pacific gathered to explore the need for a Regional Consortium to address major challenges in osteoporosis detection, and management,” said Professor John Eisman AO, Consortium Chair and Director of Clinical Translation and Advanced Education, Bone Biology Division, Garvan Institute of Medical Research, Australia.

> A consortium may be defined as an association of a broad range of willing individuals and organisations pooling resources and collaborating in common activities, to jointly bring meaningful change to the standard of care and improve patient outcomes.

“The Group identified common challenges across the Asia Pacific region, unanimously agreed it would be a good idea to have a Consortium, and subsequently identified five major challenge areas:

1. Limited physician knowledge of osteoporosis, particularly among those working in primary care;
2. The adoption of Fracture Liaison Services (FLS) in hospitals, recognised as one of the most effective models of care, which are few in number and under-resourced;
3. Lack of clinician access to diagnostic tools such as bone densitometry;
4. Lack of focus by authorities on osteoporosis as a priority disease; and a willingness by insurers to reimburse; and
5. Limited patient recognition, or understanding of, fragility fractures caused by osteoporosis and what they mean,"

Prof Eisman said. "Working groups are now being established to develop approaches to address each of these specific challenges.”

The Asia Pacific Regional Fragility Fracture Summit, staged in Singapore the following day (May 27, 2018), offered representatives of regional societies for geriatrics, orthopaedics, osteoporosis and rehabilitation the opportunity to share their cross-specialty perspectives on the acute management, rehabilitation and prevention of fragility fractures, and to explore collaborative opportunities to optimise outcomes for those living with fragility fracture through the region. 

The Summit also enabled leaders from several leading national organisations to share their experience of establishing national alliances, discuss progress in governmental policy development, and detail the patient’s perspective on fragility fractures in Asia Pacific. Leaders from international organisations also conveyed their global priorities and initiatives to participants. The meeting was co-chaired by A/Prof Derrick Chan, Superintendent, National Taiwan University Hospital, Chu-Tung Branch, Taiwan, and Dato’ Dr. Joon-Kiong Lee, Head, Department of Orthopaedic Surgery, Beacon International Specialist Centre, Malaysia.

Importantly, the Summit explored the benefits and challenges of establishing a Regional Fragility Fracture Alliance, its organisation, potential activities, including the development of a consensus statement on hip fracture management and prevention for Asia Pacific, and the identification of evidence-generation needs, region-wide.

According to Summit Co-Chair, A/Prof Chan, “The Summit united all key regional societies comprising clinicians who care for fragility fracture patients.”

A/Prof Chan further explained, “We collectively agreed on the benefits of forming a Regional Fragility Fracture Alliance that will serve as an umbrella organisation moving forward, focusing on three key areas – improving acute care, the rehabilitation of fragility fracture patients, and secondary fracture prevention. 

“The representatives of the various organisations at the Summit committed to seeking support from their Boards/Councils to progress formation of the Regional Alliance during 2018. Our first project will evaluate the feasibility of establishing a network of national hip fracture registries across the region,” A/Prof Chan said.

International Osteoporosis Foundation (IOF) CEO, Dr. Philippe Halbout, who participated in both the Regional Consortium Working Group and the Regional Fragility Fracture Summit, extended his organisation’s ongoing support of the initiative, by offering to host the second Regional Fragility Fracture Alliance meeting in Sydney, Australia on Thursday, November 29, 2018 – six months after the first meeting – “to help facilitate the implementation of future operations pertaining to the Alliance.”

The burden of fragility fractures in Asia Pacific is deserving of an innovative initiative designed to mobilise the main stakeholders of the region. IOF is delighted to assist this initiative through the sharing of our knowledge, vision, experience, skills and influence in a multidisciplinary, collaborative approach,”

said Dr. Halbout.

Stay tuned for further updates on the Asia Pacific Osteoporosis Regional Consortium and Regional Fragility Fracture Alliance. 

1. United Nations Department of Economic and Social Affairs Population Division. World Population Prospects:   
The 2017 Revision

2. International Osteoporosis Foundation. Compendium of Osteoporosis. 2017.