[Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].

Osteoporose – Definition, Risikoerfassung, Diagnose, Prävention und Therapie (Update 2024) : Leitlinie der Österreichischen Gesellschaft für Knochen- und Mineralstoffwechsel.

Austria Humans Osteoporosis / therapy Osteoporotic Fractures / prevention & control Risk Assessment Evidence-Based Medicine Practice Guidelines as Topic

FRAX Fracture probability Intervention threshold Monitoring Osteoporotic fracture

Journal

Wiener klinische Wochenschrift

ISSN: 1613-7671

Titre abrégé: Wien Klin Wochenschr

Pays: Austria

ID NLM: 21620870R

Informations de publication

Date de publication:
Oct 2024

Historique:

accepted: 23 08 2024

medline: 2 10 2024

pubmed: 2 10 2024

entrez: 2 10 2024

Statut: ppublish

Résumé

Austria is among the countries with the highest incidence and prevalence of osteoporotic fractures worldwide. Guidelines for the prevention and management of osteoporosis were first published in 2010 under the auspices of the then Federation of Austrian Social Security Institutions and updated in 2017. The present comprehensively updated guidelines of the Austrian Society for Bone and Mineral Research are aimed at physicians of all specialties as well as decision makers and institutions in the Austrian healthcare system. The aim of these guidelines is to strengthen and improve the quality of medical care of patients with osteoporosis and osteoporotic fractures in Austria. These evidence-based recommendations were compiled taking randomized controlled trials, systematic reviews and meta-analyses as well as European and international reference guidelines published before 1 June 2023 into consideration. The grading of recommendations used ("conditional" and "strong") are based on the strength of the evidence. The evidence levels used mutual conversions of SIGN (1++ to 3) to NOGG criteria (Ia to IV). The guidelines include all aspects associated with osteoporosis and osteoporotic fractures, such as secondary causes, prevention, diagnosis, estimation of the 10-year fracture risk using FRAX®, determination of Austria-specific FRAX®-based intervention thresholds, drug-based and non-drug-based treatment options and treatment monitoring. Recommendations for the office-based setting and decision makers and institutions in the Austrian healthcare system consider structured care models and options for osteoporosis-specific screening. The guidelines present comprehensive, evidence-based information and instructions for the treatment of osteoporosis. It is expected that the quality of medical care for patients with this clinical picture will be substantially improved at all levels of the Austrian healthcare system. HINTERGRUND: Österreich zählt zu den Ländern mit der höchsten Inzidenz und Prävalenz osteoporotischer Frakturen weltweit. Leitlinien zur Prävention und zum Management der Osteoporose wurden erstmals im Jahr 2010 unter der Schirmherrschaft des damaligen Hauptverbandes der Österreichischen Sozialversicherungsträger veröffentlicht und im Jahr 2017 aktualisiert. Die vorliegende umfassend aktualisierte Leitlinie der Österreichischen Gesellschaft für Knochen- und Mineralstoffwechsel (ÖGKM) richtet sich an Ärztinnen und Ärzte aller Fachrichtungen sowie an Entscheidungsträger und Institutionen im österreichischen Gesundheitssystem. Ziel dieser Leitlinie ist es, die Qualität der medizinischen Versorgung von Patienten mit Osteoporose und osteoporotischen Frakturen in Österreich zu stärken und zu verbessern. Evidenzbasierte Empfehlungen wurden unter Berücksichtigung randomisierter kontrollierter Studien, systematischer Reviews und Metaanalysen sowie europäischer und internationaler Quellleitlinien zur Osteoporose, welche bis zum 1. Juni 2023 veröffentlicht wurden, erstellt. Die verwendeten Empfehlungsstärken („bedingt“ und „stark“) basieren auf der Stärke der jeweiligen Evidenzgrade. Letztere orientieren sich an den SIGN-Kriterien (1++ bis 3), welche in NOGG-Kriterien (Ia bis IV) transformiert wurden. Die Leitlinie umfasst alle Aspekte im Zusammenhang mit Osteoporose und osteoporotischen Frakturen, einschließlich sekundärer Ursachen, Prävention, Diagnose, Erfassung der 10-Jahres-Frakturwahrscheinlichkeit mittels FRAX®, Ermittlung FRAX®-basierter Österreich-spezifischer Interventionsschwellen, medikamentöser und nichtmedikamentöser Therapieoptionen sowie Möglichkeiten des Therapiemonitorings. Empfehlungen für den niedergelassenen Bereich und Entscheidungsträger und Institutionen im österreichischen Gesundheitssystem berücksichtigen strukturierte Versorgungsmodelle sowie Möglichkeiten zur gezielten Vorsorge. Die vorliegende Leitlinie stellt umfassende, evidenzbasierte Informationen sowie Handlungsanleitungen zum Krankheitsbild der Osteoporose zur Verfügung. Es ist davon auszugehen, dass die Qualität der Versorgung von Personen mit diesem Krankheitsbild in allen Ebenen des österreichischen Gesundheitswesens entscheidend verbessert werden kann.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

These evidence-based recommendations were compiled taking randomized controlled trials, systematic reviews and meta-analyses as well as European and international reference guidelines published before 1 June 2023 into consideration. The grading of recommendations used ("conditional" and "strong") are based on the strength of the evidence. The evidence levels used mutual conversions of SIGN (1++ to 3) to NOGG criteria (Ia to IV).

RESULTS RESULTS

The guidelines include all aspects associated with osteoporosis and osteoporotic fractures, such as secondary causes, prevention, diagnosis, estimation of the 10-year fracture risk using FRAX®, determination of Austria-specific FRAX®-based intervention thresholds, drug-based and non-drug-based treatment options and treatment monitoring. Recommendations for the office-based setting and decision makers and institutions in the Austrian healthcare system consider structured care models and options for osteoporosis-specific screening.

CONCLUSION CONCLUSIONS

The guidelines present comprehensive, evidence-based information and instructions for the treatment of osteoporosis. It is expected that the quality of medical care for patients with this clinical picture will be substantially improved at all levels of the Austrian healthcare system.

ZUSAMMENFASSUNG UNASSIGNED

HINTERGRUND: Österreich zählt zu den Ländern mit der höchsten Inzidenz und Prävalenz osteoporotischer Frakturen weltweit. Leitlinien zur Prävention und zum Management der Osteoporose wurden erstmals im Jahr 2010 unter der Schirmherrschaft des damaligen Hauptverbandes der Österreichischen Sozialversicherungsträger veröffentlicht und im Jahr 2017 aktualisiert. Die vorliegende umfassend aktualisierte Leitlinie der Österreichischen Gesellschaft für Knochen- und Mineralstoffwechsel (ÖGKM) richtet sich an Ärztinnen und Ärzte aller Fachrichtungen sowie an Entscheidungsträger und Institutionen im österreichischen Gesundheitssystem. Ziel dieser Leitlinie ist es, die Qualität der medizinischen Versorgung von Patienten mit Osteoporose und osteoporotischen Frakturen in Österreich zu stärken und zu verbessern.

METHODEN METHODS

Evidenzbasierte Empfehlungen wurden unter Berücksichtigung randomisierter kontrollierter Studien, systematischer Reviews und Metaanalysen sowie europäischer und internationaler Quellleitlinien zur Osteoporose, welche bis zum 1. Juni 2023 veröffentlicht wurden, erstellt. Die verwendeten Empfehlungsstärken („bedingt“ und „stark“) basieren auf der Stärke der jeweiligen Evidenzgrade. Letztere orientieren sich an den SIGN-Kriterien (1++ bis 3), welche in NOGG-Kriterien (Ia bis IV) transformiert wurden.

ERGEBNISSE UNASSIGNED

Die Leitlinie umfasst alle Aspekte im Zusammenhang mit Osteoporose und osteoporotischen Frakturen, einschließlich sekundärer Ursachen, Prävention, Diagnose, Erfassung der 10-Jahres-Frakturwahrscheinlichkeit mittels FRAX®, Ermittlung FRAX®-basierter Österreich-spezifischer Interventionsschwellen, medikamentöser und nichtmedikamentöser Therapieoptionen sowie Möglichkeiten des Therapiemonitorings. Empfehlungen für den niedergelassenen Bereich und Entscheidungsträger und Institutionen im österreichischen Gesundheitssystem berücksichtigen strukturierte Versorgungsmodelle sowie Möglichkeiten zur gezielten Vorsorge.

SCHLUSSFOLGERUNG UNASSIGNED

Die vorliegende Leitlinie stellt umfassende, evidenzbasierte Informationen sowie Handlungsanleitungen zum Krankheitsbild der Osteoporose zur Verfügung. Es ist davon auszugehen, dass die Qualität der Versorgung von Personen mit diesem Krankheitsbild in allen Ebenen des österreichischen Gesundheitswesens entscheidend verbessert werden kann.

Autres résumés

Type: Publisher (ger)

Identifiants

DOI: 10.1007/s00508-024-02441-2 PMID: 39356323

pubmed: 39356323

doi: 10.1007/s00508-024-02441-2

pii: 10.1007/s00508-024-02441-2

doi:

Types de publication

Journal Article Practice Guideline English Abstract

Langues

ger

Sous-ensembles de citation

Pagination

599-668

Informations de copyright

Références

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