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Osteoporosis International
Published in: Osteoporosis International 1/2021

Open Access 01-01-2021 | Osteoporosis | Original Article

A scorecard for osteoporosis in Canada and seven Canadian provinces

Authors: D.L. Kendler, J.D. Adachi, J.P. Brown, A.G. Juby, C.S. Kovacs, C. Duperrouzel, R.K. McTavish, C. Cameron, L. Slatkovska, N. Burke

Published in: Osteoporosis International | Issue 1/2021

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Abstract

Summary

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.
Appendix
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Metadata
Title
A scorecard for osteoporosis in Canada and seven Canadian provinces
Authors
D.L. Kendler
J.D. Adachi
J.P. Brown
A.G. Juby
C.S. Kovacs
C. Duperrouzel
R.K. McTavish
C. Cameron
L. Slatkovska
N. Burke
Publication date
01-01-2021
Publisher
Springer London
Published in
Osteoporosis International / Issue 1/2021
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-020-05554-2

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