Can new information and communication technologies help in the management of osteoporosis?

Osteoporosis is a serious public health issue and a major cause of bone fracture worldwide. These fractures are associated with major risk of morbidity such as chronic pain or long term disability, early mortality and higher healthcare costs [1]. Three important issues are in the way of the management of osteoporosis. First is population awareness regarding osteoporosis prevention and self-management. Among all risk factors for osteoporosis and fractures, some are modifiable such as smoking, high alcohol intake or low physical activity level [2]. However, population knowledge around osteoporosis is limited, even among diagnosed patients [3]. A better knowledge of modifiable risk factors of osteoporosis as well as the importance of good life habits may have an impact on osteoporosis burden. Second is treatment compliance. A recent decrease in the incidence of fracture has been reported in some countries. Interestingly, this has coincided with an increased use of osteoporosis treatments in these countries [4]. Even if there is no clear causal relationship between this increased use of osteoporosis medications and the decreased rate of hip fracture, this fact underlines the importance of the pharmacological management of osteoporosis. In addition, several studies have shown that a greater adherence to osteoporosis medication can reduce the number of fractures [4–6]. Compliance to medication for chronic diseases typically ranges from 50 to 60% and it is usually lower when the disease is asymptomatic as in osteoporosis. Weycker et al. showed that the overall risk of adherence failure was 47% at 3 months, 70% at 1 year and 84% at 3 years [7]. These numbers may vary according to the drug considered but they are comparable for all therapies. Our team has shown that at the end of the first year of therapy, only 39.45% of women continued to take their medication [8]. We showed that the relative risk reduction for hip fracture was 60% (p < 0.0001) for persistent compared to nonpersistent patients. In fact, and because of poor compliance, a large majority of women are not adequately protected against fracture [7], which continues to generate costs [9]. It is a considerable challenge for healthcare systems to ensure adequate resources to support individuals with chronic diseases and encourage them to assiduously follow their treatment [5]. Promoting interventions that could improve adherence is worthwhile and may reduce the rate of osteoporosis as well as the related complications [8]. Finally is awareness among general practitioners (GPs) regarding the disease. In a recent study, GPs were not particularly concerned about osteoporosis in their patients or in the general population. They seem to rank diabetes, osteoarthritis, cardiovascular part of Can new information and communication technologies help in the management of osteoporosis?