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WHO benchmarks for equitable hip-fracture care and osteoporosis treatment in older people

WHO benchmarks for equitable hip-fracture care and osteoporosis treatment in older people
WHO benchmarks for equitable hip-fracture care and osteoporosis treatment in older people

Hip fractures cause major morbidity, mortality and long-term disability among older persons worldwide. The World Health Organization has defined two key indicators within the framework of the UN Decade of Healthy Ageing to measure health system performance in providing care for older adults with hip fractures: the proportion who receive surgery within 48 h of fracture; and the proportion who receive pharmacological treatment for osteoporosis post-fracture. This Perspective article, which describes the clinical importance of these indicators, their amenability for adoption and implications for health equity, is based on findings from audits, guidelines and key literature. Numerous evidence-based solutions - for example, fracture liaison services, orhtogeriatric care models and digital tools support hip-fracture management, yet major barriers remain, such as data gaps, system preparedness and pathway variability. New or modified policies developed by national governments, ministries of health and other relevant authorities and tailored to specific geopolitical contexts are urgently needed to enable the implementation of timely surgical care and secondary fracture prevention strategies aligned with the WHO indicators. Improved health information systems to measure performance and to ensure translation to real-world changes in the lives of older people worldwide are of paramount importance.

1759-4790
Chandran, Manju
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Thiyagarajan, Jotheeswaran A
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Alokail, Majed
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Bruyère, Olivier
ba727e54-ca17-4fa8-be3d-4729fb4b8c0d
Harvey, Nicholas C
ce487fb4-d360-4aac-9d17-9466d6cba145
Rizzoli, Rene
682e7962-68b1-469e-8049-754ad7892221
Veronese, Nicola
a9a97f63-a828-45a3-bae0-68182c5a44fd
Reginster, Jean-Yves
08b05e27-73dd-4ce9-90e5-d64ec922147a
Chandran, Manju
0906289a-b6cb-47ea-836e-5bb8ec4bd7db
Thiyagarajan, Jotheeswaran A
3f543bed-c612-4b87-847d-85ded231aa07
Alokail, Majed
9adf2d61-d9f7-4095-bc36-701f0680646a
Bruyère, Olivier
ba727e54-ca17-4fa8-be3d-4729fb4b8c0d
Harvey, Nicholas C
ce487fb4-d360-4aac-9d17-9466d6cba145
Rizzoli, Rene
682e7962-68b1-469e-8049-754ad7892221
Veronese, Nicola
a9a97f63-a828-45a3-bae0-68182c5a44fd
Reginster, Jean-Yves
08b05e27-73dd-4ce9-90e5-d64ec922147a

Chandran, Manju, Thiyagarajan, Jotheeswaran A, Alokail, Majed, Bruyère, Olivier, Harvey, Nicholas C, Rizzoli, Rene, Veronese, Nicola and Reginster, Jean-Yves (2025) WHO benchmarks for equitable hip-fracture care and osteoporosis treatment in older people. Nature Rheumatology Reviews. (doi:10.1038/s41584-025-01319-5).

Record type: Review

Abstract

Hip fractures cause major morbidity, mortality and long-term disability among older persons worldwide. The World Health Organization has defined two key indicators within the framework of the UN Decade of Healthy Ageing to measure health system performance in providing care for older adults with hip fractures: the proportion who receive surgery within 48 h of fracture; and the proportion who receive pharmacological treatment for osteoporosis post-fracture. This Perspective article, which describes the clinical importance of these indicators, their amenability for adoption and implications for health equity, is based on findings from audits, guidelines and key literature. Numerous evidence-based solutions - for example, fracture liaison services, orhtogeriatric care models and digital tools support hip-fracture management, yet major barriers remain, such as data gaps, system preparedness and pathway variability. New or modified policies developed by national governments, ministries of health and other relevant authorities and tailored to specific geopolitical contexts are urgently needed to enable the implementation of timely surgical care and secondary fracture prevention strategies aligned with the WHO indicators. Improved health information systems to measure performance and to ensure translation to real-world changes in the lives of older people worldwide are of paramount importance.

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More information

Accepted/In Press date: 15 October 2025
e-pub ahead of print date: 6 November 2025
Additional Information: Publisher Copyright: © Springer Nature Limited 2025.

Identifiers

Local EPrints ID: 507317
URI: http://eprints.soton.ac.uk/id/eprint/507317
ISSN: 1759-4790
PURE UUID: 82f0f692-3496-4147-8291-c471878d2457
ORCID for Nicholas C Harvey: ORCID iD orcid.org/0000-0002-8194-2512

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Date deposited: 03 Dec 2025 17:43
Last modified: 04 Dec 2025 02:37

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Contributors

Author: Manju Chandran
Author: Jotheeswaran A Thiyagarajan
Author: Majed Alokail
Author: Olivier Bruyère
Author: Rene Rizzoli
Author: Nicola Veronese
Author: Jean-Yves Reginster

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