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Global impact of COVID-19 on non-communicable disease management: descriptive analysis of access to FRAX fracture risk online tool for prevention of osteoporotic fractures

Global impact of COVID-19 on non-communicable disease management: descriptive analysis of access to FRAX fracture risk online tool for prevention of osteoporotic fractures
Global impact of COVID-19 on non-communicable disease management: descriptive analysis of access to FRAX fracture risk online tool for prevention of osteoporotic fractures
Summary
The COVID-19 pandemic, and its management, is markedly impacting the management of osteoporosis as judged by access to online FRAX fracture risk assessments. Globally, access was 58% lower in April than in February 2020. Strategies to improve osteoporosis care, with greater use of fracture risk assessments, offer a partial solution.

Introduction
The COVID-19 pandemic is having a significant detrimental impact on the management of chronic diseases including osteoporosis. We have quantified the global impact by examining changes in the usage of online FRAX fracture risk assessments before and after the declaration of the pandemic (11 March 2020).

Methods
The study comprised a retrospective analysis using GoogleAnalytics data on daily sessions on the FRAX® website (www.sheffield.ac.uk/FRAX) from November 2019 to April 2020 (main analysis period February–April 2020), and the geographical source of that activity.

Results
Over February–April 2020, the FRAX website recorded 460,495 sessions from 184 countries, with 210,656 sessions in February alone. In March and April, the number of sessions fell by 23.1% and 58.3% respectively, a pattern not observed over the same period in 2019. There were smaller reductions in Asia than elsewhere, partly related to earlier and less-marked nadirs in some countries (China, Taiwan, Hong Kong, South Korea and Vietnam). In Europe, the majority of countries (24/31, 77.4%) reduced usage by at least 50% in April. Seven countries showed smaller reductions (range − 2.85 to − 44.1%) including Poland, Slovakia, Czech Republic, Germany, Norway, Sweden and Finland. There was no significant relationship between the reduction in FRAX usage and measures of disease burden such as COVID-attributed deaths per million of the population.

Conclusion
This study documents a marked global impact of the COVID-19 pandemic on the management of osteoporosis as reflected by FRAX online fracture risk assessments. The analysis suggests that impact may relate to the societal and healthcare measures taken to ameliorate the pandemic.
0937-941X
1-8
McCloskey, Eugene V.
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Harvey, Nicholas
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Johansson, Helena
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Lorentzon, Mattias
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Vandenput, Lisbeth
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Liu, Enwu
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Kanis, John A.
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McCloskey, Eugene V.
2f057a16-3d4e-4597-80c7-6ce47f969c78
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Johansson, Helena
04f12338-4dd1-437b-b9bc-e0884130c215
Lorentzon, Mattias
9d78ed25-2b0c-46c5-a2db-a8b246af0956
Vandenput, Lisbeth
51275083-bd2d-4d28-9b3b-f07c4d55aeb8
Liu, Enwu
08027c15-9e71-44bb-9623-3081f5f6492d
Kanis, John A.
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McCloskey, Eugene V., Harvey, Nicholas, Johansson, Helena, Lorentzon, Mattias, Vandenput, Lisbeth, Liu, Enwu and Kanis, John A. (2020) Global impact of COVID-19 on non-communicable disease management: descriptive analysis of access to FRAX fracture risk online tool for prevention of osteoporotic fractures. Osteoporosis International, 1-8. (doi:10.1007/s00198-020-05542-6).

Record type: Article

Abstract

Summary
The COVID-19 pandemic, and its management, is markedly impacting the management of osteoporosis as judged by access to online FRAX fracture risk assessments. Globally, access was 58% lower in April than in February 2020. Strategies to improve osteoporosis care, with greater use of fracture risk assessments, offer a partial solution.

Introduction
The COVID-19 pandemic is having a significant detrimental impact on the management of chronic diseases including osteoporosis. We have quantified the global impact by examining changes in the usage of online FRAX fracture risk assessments before and after the declaration of the pandemic (11 March 2020).

Methods
The study comprised a retrospective analysis using GoogleAnalytics data on daily sessions on the FRAX® website (www.sheffield.ac.uk/FRAX) from November 2019 to April 2020 (main analysis period February–April 2020), and the geographical source of that activity.

Results
Over February–April 2020, the FRAX website recorded 460,495 sessions from 184 countries, with 210,656 sessions in February alone. In March and April, the number of sessions fell by 23.1% and 58.3% respectively, a pattern not observed over the same period in 2019. There were smaller reductions in Asia than elsewhere, partly related to earlier and less-marked nadirs in some countries (China, Taiwan, Hong Kong, South Korea and Vietnam). In Europe, the majority of countries (24/31, 77.4%) reduced usage by at least 50% in April. Seven countries showed smaller reductions (range − 2.85 to − 44.1%) including Poland, Slovakia, Czech Republic, Germany, Norway, Sweden and Finland. There was no significant relationship between the reduction in FRAX usage and measures of disease burden such as COVID-attributed deaths per million of the population.

Conclusion
This study documents a marked global impact of the COVID-19 pandemic on the management of osteoporosis as reflected by FRAX online fracture risk assessments. The analysis suggests that impact may relate to the societal and healthcare measures taken to ameliorate the pandemic.

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More information

Accepted/In Press date: 7 July 2020
e-pub ahead of print date: 14 October 2020

Identifiers

Local EPrints ID: 444564
URI: http://eprints.soton.ac.uk/id/eprint/444564
ISSN: 0937-941X
PURE UUID: 7e25660b-972c-4146-bb17-d33c2072f4e5
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 26 Oct 2020 17:30
Last modified: 13 Oct 2021 04:01

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Contributors

Author: Eugene V. McCloskey
Author: Nicholas Harvey ORCID iD
Author: Helena Johansson
Author: Mattias Lorentzon
Author: Lisbeth Vandenput
Author: Enwu Liu
Author: John A. Kanis

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