Table 2.

Reasons for suboptimal fracture prevention.

Why is fracture prevention suboptimal?
Fractures do occur, mainly in the elderly
Fear of severe side effects
Lack of education in professionals and in the lay public
Lack of engagement: osteoporosis is a low medical priority
Lack of coordination between health care systems
Inadequate access to diagnostics such as DXA and VFA
Suboptimal predictive value of diagnostic techniques
The treatment gap
Low adherence and compliance to anti-osteoporotic drugs
Generic drugs, nocebo-effect*
Lack of focus on muscle strength and fall prevention

^*A negative expectation of a phenomenon causes it to have a more negative effect than it otherwise would.

DXA, dual-energy X-ray absorptiometry; VFA, vertebral fracture assessment.