HKU's COSA Osteoporosis Community Screening Program Identifies Over 1,000 High-Risk Seniors from 5,000 Screenings
HKU's COSA Osteoporosis Community Screening Program Identifies Over 1,000 High-Risk Seniors from 5,000 Screenings
Senin, 07 Oktober 2024 | 09:49
Professor Cheung Ching-lung, Associate Professor of the Department of Pharmacology and Pharmacy at the LKS Faculty of Medicine, HKU, and Convenor of the COSA Community Screening Programme, alongside officiating guests, co-organizers and programme advisors, officially kicks off World Osteoporosis Day 2024 and the COSA screening for over 1,020 elderly participants.
HONG KONG SAR -
Media OutReach Newswire
- 6 October 2024 - The Department of Pharmacology and Pharmacy, LKS
Faculty of Medicine, The University of Hong Kong, has successfully
launched a large-scale community program this year, utilizing the
innovative COSA screening tool to identify over 1,000 individuals at
high risk for osteoporosis. This initiative has significantly increased
the rate of medical follow-ups among seniors, establishing a model for
enhancing bone health within primary care settings.
Senior Health Ambassadors Unite Against Osteoporosis
Osteoporosis is a common bone disease, affecting approximately 30% of
women and 8% of men in Hong Kong. However, the condition often goes
undetected, with many patients only becoming aware of their diagnosis
after experiencing a fragility fracture. Such fractures not only impair
mobility but also significantly increase mortality risk. Furthermore,
studies indicate that the annual treatment cost for hip fractures in
Hong Kong can reach as high as HKD 660 million, highlighting the
substantial burden of fragility fractures on patients, caregivers, and
the public healthcare system.
To identify individuals at risk for osteoporosis and prevent fragility
fractures, The Department of Pharmacology and Pharmacy, LKS Faculty of
Medicine, The University of Hong Kong, has launched a territory-wide
COSA Osteoporosis Community Screening Programme. This initiative, in
collaboration with over 20 NGOs and mutli-disciplinary medical
societies, spans various districts across Hong Kong. It employs the
innovative Chinese Osteoporosis Screening Algorithm (COSA), specifically
designed for the Chinese population. The programme aims to screen and
educate individuals aged 50 and above about the importance of
osteoporosis awareness and prevention.
As of August 2024, over 5,000 eligible seniors have completed the
screening. The results revealed that nearly 30% (approximately 1,600
seniors) were identified as high-risk individuals who require referrals
to doctors for follow-up and dual-energy X-ray absorptiometry (DXA)
scans for diagnosis and treatment planning. The screening process also
included an awareness survey, which indicated that many seniors have a
limited understanding of osteoporosis and underestimate its serious
consequences.
Key findings from the awareness survey are as follows:
1. Approximately 80% of respondents were unaware that osteoporosis is a "silent disease"
Most patients do not exhibit any symptoms, yet only a small percentage
(24%) of seniors recognized that osteoporosis can be asymptomatic. Many
respondents mistakenly believed that knee pain (49%) is a symptom of
osteoporosis, potentially leading them to overlook the seriousness of
the disease. This lack of knowledge may result in delayed diagnosis and
treatment.
2. Only about 20% of seniors had undergone a DXA scan
DXA is the gold standard for diagnosing osteoporosis; however, the
survey found that only 22% of respondents had received a DXA
examination, and over half had not participated in any
osteoporosis-related screenings. This suggests a significant lack of
awareness on bone health amongst senior individuals. Furthermore, the
low DXA scan rates among seniors, especially when DXA scans are commonly
available indicate a significant gap in osteoporosis screening and
awareness. This suggests a need for improved education and access to
bone health assessments.
3. The "screening followed by referral" model successfully
encouraged over half of high-risk individuals to seek medical follow-up
Based on the findings from follow-up with high-risk individuals,
approximately 60% consulted public or private doctors, and nearly 40%
successfully underwent DXA scans. Of those diagnosed, around 90% were
confirmed to have osteoporosis or osteopenia and began receiving
treatment. This demonstrates that COSA can effectively identify
osteoporosis patients, prompting early medical consultation to prevent
fragility fractures. Furthermore, COSA is a hassle-free, publicly
available, a risk predictor tool with just 4 questions that can be
completed within 1 minute. The tool can effectively identify high risk
individuals that needs further diagnosis with DXA scans. Hence, the use
of COSA risk predictor tool is also cost-effective whereby DXA scans and
resources can be prioritized for high-risk individuals.
Professor Cheung Ching-lung, Associate Professor, The Department of
Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of
Hong Kong, and Convenor of the COSA Osteoporosis Community Screening
Programme, stated, "The survey highlights a critical lack of
awareness about osteoporosis among seniors in Hong Kong. Very few
individuals undergo regular bone density testing. Osteoporosis is a
condition that can be prevented, diagnosed, and treated. Early risk
assessments are essential for preventing and managing the disease,
increasing bone density, and reducing the risk of fractures." He further
noted that international studies have shown that employing risk
assessment tools in primary care settings for seniors is both
cost-effective and significantly reduces the incidence of fractures and
associated treatment costs, ultimately benefiting society as a whole.
A Three-Pronged Approach to Osteoporosis Prevention
To effectively tackle the threat of osteoporosis, over 20 experts from
various medical societies and NGOs convened for a cross-sector meeting
in June 2024. Professor Cheung Ching-lung noted that the expert group
acknowledged the necessity of a three-pronged approach to successfully
prevent osteoporosis:
1. Public Education: Educating the community, especially senior
individuals, about fragility fractures and osteoporosis, including its
implications, prevention, treatment and long-term care required for the
disease.
2. Proactive Screening: Widely utilizing the COSA risk
predication tool by incorporating COSA risk prediction tool as part of
routine service in healthcare touchpoints such as elderly centers,
district health centers and community pharmacists to identify high-risk
individuals. High risk individuals can later on be referred for
diagnosis with DXA scans. Utilize healthcare vouchers issued by the
Department of Health for seniors can be used to as a co-payment DXA
scans to encourage senior individuals to undergo osteoporosis screening.
3. Appropriate Treatment: Strengthening the roles of elderly
centers, community health centers and pharmacies in ensuring a long-term
care of osteoporosis elderlies. Enhance training for family doctors in
managing osteoporosis, and establishing a "co-payment model" to reduce
financial burden of patients to seek private healthcare services for
timely treatment whilst preventing fragility fractures which
subsequently resulting in broader financial and disability burden.
In response to World Osteoporosis Day on October 20, representatives
from the HKSAR Government, healthcare community, and NGOs, along with
nearly a hundred volunteers, gathered at Tuen Mun Ching Chung Koon to
conduct a large-scale community screening today (October 6). This event
screened over 1,020 local seniors aged 60 and above (symbolizing October
20) using COSA to raise community and citywide awareness of
osteoporosis.