Management of fracture risk in patients with chronic obstructive pulmonary disease (COPD): building a uk consensus through healthcare professional and patient engagement

Jayes, LR ORCID: https://orcid.org/0000-0002-5240-6286, Gupta, A, Holmes, S, Sahota, O, Canavan, M, Elkin, SL, Lim, K, Murphy, AC, Singh, S, Towlson, EA, Ward, H, Scullion, J, McKeever, TM and Bolton, CE, 2020. Management of fracture risk in patients with chronic obstructive pulmonary disease (COPD): building a uk consensus through healthcare professional and patient engagement. International Journal of Chronic Obstructive Pulmonary Disease, 15, pp. 1377-1390. ISSN 1178-2005

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Abstract

Introduction: Osteoporosis and bone fractures are common in chronic obstructive pulmonary disease (COPD) and contribute significantly to morbidity and mortality. Current national guidance on COPD management recommends addressing bone health in patients, however, does not detail how. This consensus outlines key elements of a structured approach to managing bone health and fracture risk in patients with COPD.

Methods: A systematic approach incorporating multifaceted methodologies included detailed patient and healthcare professional (HCP) surveys followed by a roundtable meeting to reach a consensus on what a pathway would look like.

Results: The surveys revealed that fracture risk was not always assessed despite being recognised as an important aspect of COPD management by HCPs. The majority of the patients also stated they would be receptive to discussing treatment options if found to be at risk of osteoporotic fractures. Limited time and resource allocation were identified as barriers to addressing bone health during consultations. The consensus from the roundtable meeting was that a proactive systematic approach to assessing bone health should be adopted. This should involve using fracture risk assessment tools to identify individuals at risk, investigating secondary causes of osteoporosis if a diagnosis is made and reinforcing non-pharmacological and preventative measures such as smoking cessation, keeping active and pharmacological management of osteoporosis and medicines management of corticosteroid use. Practically, prioritising patients with important additional risk factors, such as previous fragility fractures, older age and long-term oral corticosteroid use for an assessment, was felt required.

Conclusion: There is a need for integrating fracture risk assessment into the COPD pathway. Developing a systematic and holistic approach to addressing bone health is key to achieving this. In tandem, opportunities to disseminate the information and educational resources are also required.

Item Type:	Journal article
Publication Title:	International Journal of Chronic Obstructive Pulmonary Disease
Creators:	Jayes, L.R., Gupta, A., Holmes, S., Sahota, O., Canavan, M., Elkin, S.L., Lim, K., Murphy, A.C., Singh, S., Towlson, E.A., Ward, H., Scullion, J., McKeever, T.M. and Bolton, C.E.
Publisher:	Dove Press
Date:	15 June 2020
Volume:	15
ISSN:	1178-2005
Identifiers:	Number Type 10.2147/copd.s233398 DOI 1855711 Other
Rights:	This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
Divisions:	Schools > School of Social Sciences
Record created by:	Jonathan Gallacher
Date Added:	31 Jan 2024 11:33
Last Modified:	31 Jan 2024 11:33
URI:	https://irep.ntu.ac.uk/id/eprint/50774

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