New education modules to assist regional management of osteoporosis

The Asia Pacific Consortium on Osteoporosis (APCO), comprising experts on osteoporosis in the Asia-Pacific region, recently launched the APCO HCP Education modules. MIMS Doctor spoke to Dr Manju Chandran, APCO chairperson, to learn more about the modules.

Q: Do we have solid data to show that osteoporosis is on the rise in this region?

A: Yes. Data from Singapore, China and Hong Kong certainly suggest this.  The number of hip fractures will increase from 1,124,060 in 2018, to 2,563,488 in 2050, a 2.28-fold increase. This increase is mainly due to the changes in population demographics, especially in China and India, which have the largest population size.

 

The direct cost of hip fracture will increase from US$9.5 billion in 2018 to US$15 billion in 2050, resulting in a 1.59-fold increase.

  

Q: Can you expand on the nature of the osteoporosis resource? Is it a Continuous Professional Development/Continuing Medical Education type material or is it more like online reading materials to help with decision-making and management of osteoporosis?

A: The APCO Health Care Professional (HCP) Peer to Peer Educational Modules comprise 232 slides. The slides are organized into 17 modules—one module for each of the 16 APCO Framework Clinical Standards, and one module on recently emerging themes in osteoporosis care.

 

The slides are structured for use in their entirety, or in blocks. The slides are not intended to provide CPD/CME, but will form an invaluable resource for practicing clinicians, as well as guidelines development authorities and policy makers, because they provide the evidence base for each of the standards and emerging themes advocated in the APCO Framework.

 

Q: Will GPs have a big role to play in the coming years in terms of managing osteoporosis?

A: Yes, osteoporosis is a chronic condition that ideally should be managed at primary care level.  In Singapore for instance, a large emphasis is placed on “right-siting” whereby it is recommended that patients with chronic diseases such as osteoporosis be managed in the primary care and poly clinics. This would not only reduce the burden on overcrowded hospitals and specialty clinics, but also enable the more holistic care that GPs can provide.

 

Q With many Asians being lactose intolerant, what is the best way of keeping calcium intake at optimal levels diet-wise?

A: Bioavailability of calcium from dairy products is excellent. However, for those who are lactose intolerant, there are several dairy-free food products that are rich sources of calcium. These include almonds, calcium-fortified soy milk; leafy greens such as spinach and kailan; dried anchovies with bones, sardines, and bean curd (tofu).

 

Q: What level of activity (exercise) is necessary to maintain bone health and prevent osteoporosis?

A: Though the evidence on the effect of exercise on bone mineral density per se is still inconclusive, there is no doubt that exercise can have a positive impact on improving flexibility and muscle strength and preventing falls. A combination of aerobic, resistance, balance and stretch exercises are recommended. Moderate intensity exercises at least, are essential.

 

Some general recommendations:

How often do people need to exercise to improve their bone and muscle strength?
Weight-bearing exercise with impact
Exercise levels appropriate for their health and mobility
People without osteoporosis, and most people with osteoporosis	About 50 moderate impacts on most days. This could be jumping, skipping, jogging, or hopping.
For those with spinal fractures or inability to do moderate exercise	20 minutes of lower impact exercise on most days
For those who are not physically strong or unable to do regular exercise	Aim to avoid prolonged sitting. Stand up for a few minutes every hour.

 

  

Manju’s message to HCPs
It behoves us as HCPs in the Asia-Pacific region—home to the fastest ageing population in the world and a region predicted to have more than 50 percent of the world’s osteoporotic fractures by the year 2050—to sit up and start taking action against this silent disease which is osteoporosis. 

 

Osteoporosis experts can use the new APCO HCP Education Modules either in full, or in part, to inspire and further inform their peers and professional communities on those at high risk for fractures who require identification and assessment based on their medical and fracture history, risk factors, co-occurring diseases, country-specific osteoporosis screening tool results, and falls risk.

 

The information provided in the Educational modules also includes administration, duration, and monitoring of/ adherence to various treatment interventions and their associated side-effects as well as the critical need for long-term management plans. The modules will be of invaluable help to both GPs and specialists while caring for their patients with osteoporosis.        

 

For further information, go to: https://apcobonehealth.org/apco-education-modules/