Outpatient Care for Osteoporosis Patients in Germany

mass, breakdown of the microarchitecture of the bones, and an increased risk of fracture. Especially postmenopausal women are at risk of developing osteoporosis. According to 1994 data from the World Health Organization, some 30% of postmenopausal women worldwide have osteoporosis. In Germany, an estimated 4 to 7 million people are affected by osteoporosis, but the exact prevalence of the disease is not known (1-5). The enormous social and economic consequences are caused primarily by osteoporosis-related fractures. These complications are responsible for more hospital bed days per year than diabetes, myocardial infarction, or breast cancer (6-7). Numerous studies found a fracture-reducing effect in several drugs, including bisphosphonates, raloxifene, and oestrogens, especially in patients who have had a fracture and in patients with a 10-year risk of fracture of more than 30%. The average number needed to treat (NNT) for three to five years is 15 to 30 (8-11). The extent to which calcium and vitamin D can lower susceptibility to fractures is not clear (12-13). Early identification of people with a high risk of developing the disease is vitally important, as is educating them about preventive measures; equally important is early identification of people who already have the disease and initiating treatment.