Osteoporosis management in a rural community hospital in Japan: A cross-sectional study

Objectives: Osteoporosis is a condition characterized by decreased bone strength and an increased risk of fragility fractures. Its prevalence is increasing in developed countries, highlighting the need for appropriate diagnosis and intervention. However, in practice, adequate testing and treatment are not often provided. Therefore, in this study, we investigated the status of osteoporosis management in a rural community hospital in Japan. Design: Cross-sectional. Setting: Department of General Medicine from a rural community hospital, Japan. Participants: A total of 984 women aged ≥65 years who were recommended to undergo osteoporosis screening. Primary and secondary outcome measures: Bone mineral density (BMD) testing rate and characteristics of patients who underwent these tests, including diagnosis and treatment rates for osteoporosis. Results: The BMD testing rate was 14%. Despite being at risk of osteoporosis, older patients and those requiring nursing care showed a lower rate of testing. The proportion of patients diagnosed withosteoporosis was 41%, and the treatment rate was 19%. Conclusions: The management of osteoporosis in a rural Japanese community hospital was found to be inadequate. The rate of BMD testing was low, particularly among older adults and those requiring nursing care. This finding suggests that these patients may be considered to have osteoporosis without confirming the diagnosis through testing based on their age alone, raising the question of ageism and highlighting the importance of personalized healthcare that is not based solely on age. Further cohort studies and intervention strategies are required to fully investigate these issues.