It is time for everyone to own the bone

• Published in: Osteoporosis international 2011-08, Vol.22 (Suppl 3), p.477-482
• Main Author: Bunta, Andrew D.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Bone Density Conservation Agents - therapeutic use; Delivery of Health Care, Integrated - organization & administration; Diseases of the osteoarticular system; Endocrinology; Female; Fractures; Humans; Injuries of the limb. Injuries of the spine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Opinion Paper; Orthopedics; Osteoporosis; Osteoporosis - diagnosis; Osteoporosis - drug therapy; Osteoporosis. Osteomalacia. Paget disease; Osteoporotic Fractures - prevention & control; Patient Care Team - organization & administration; Quality Improvement - organization & administration; Quality of care; Rheumatology; Traumas. Diseases due to physical agents; United States
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-011-1704-0

The current status of the population's bone health has caused considerable concern in the USA and around the world. In keeping with that situation, the US Surgeon General issued a special report on Bone Health and Osteoporosis in 2004 calling attention to a rapidly increasing healthcare problem especially linked to a growing and aging population base. The report specifically cited the medical profession's failure to treat the underlying osteoporosis in elderly individuals with fragility fractures with a 20% treatment rate as the norm. It was noted that an individual fracture was a sentinel event that provided a “teachable moment” for the patient in order to prevent future fractures. Additional statistics revealed the annual total number of fragility fractures, more than two million, exceeded the combined annual total incidence of stroke, myocardial infarction, and breast cancer. Realizing that the American Heart Association and the cardiology community had a successful US national program encouraging the use of beta blockers in patients after myocardial infarction in order to prevent recurrences, the American Orthopaedic Association (AOA) embarked on a course leading to the development of a program to improve bone healthcare in elderly patients with fragility fractures. The cardiology project, “Get With The Guidelines” (GWTG), included a registry in order to document improvement in cardiac patient care. Therefore, the AOA, a leadership group of orthopaedic surgeons, decided it was time to engage the orthopaedic community in a quality improvement initiative patterned after GWTG. Thus, Own the Bone was created as a multidisciplinary program in order to engage patients and physicians from different specialties who might be involved with the bone health concerns of patients with fragility fractures. After the success of a pilot study from 2005 to 2006, Own the Bone was launched as a US national quality improvement program in 2009. It involves a turnkey protocol, utilizing a web-based registry, in order to complete ten basic measures of patient care in patients 50 years and older with fragility fractures. Those measures center on information and counseling on nutrition, physical activity, lifestyle changes, diagnosis and treatment of osteoporosis, and communication to the patient and primary care physician, mentioning the need for osteoporosis care. While this project was initially meant to be implemented in a hospital setting, it can also be applied in an outp