The osteoporosis diagnosis and treatment gaps and risk factors among women aged ≥50 years

Background: Despite the availability of diagnostic equipment and effective drugs to diagnose and treat osteoporosis, only a minority of women are cared. The aim of this study was to investigate of the osteoporosis care gaps among postmenopausal women. Methods This cross-sectional observational study in one the province of Iran, collected data from women aged ≥ 50 years. Initially, participants were surveyed through FRAX. Then, a questionnaire was developed in 3 concepts (socioeconomic, diagnosis and medication initiation). Medication adherence was assessed using the validated OS-MMAS-8 questionnaire. Results A total of 998 women with a mean age of 64.6 ± 10.4 participated in this study. Overall, 346(34.6%) women were at high risk of fragility fractures through FRAX. 130(37.5%) women at high fracture risk underwent BMD, and 109 (31.5%) were diagnosed with osteoporosis. 44 (44.9%) patients adhere to the treatment and 54 (55.1%) patients did not. Overall, 9(20.5%), 35(79.5%) and 0 had low, medium, and high OS-MMAS-8 scores. The diagnosis and treatment gaps were 68.5% and 71.6%, respectively. Older age (OR = 0.97, 95%CI: 0.94–1.00, P =0.090), elementary education (OR = 4.80, 95%CI: 1.65–13.99, P = 0.004) and awareness of OP (OR = 6.03, 95%CI: 3.38–10.73, P < 0.001) were associated with diagnosis gap. Also, rural residence (OR = 0.45, 95%CI: 0.14–1.42, P = 0.175) and awareness of OP (OR = 4.34, 95%CI: 0.88–21.30, P = 0.071) is an independent risk factor for treatment gap. Conclusions There is a large OP care gap in women aged ≥ 50 years at increased risk of FF in Iran. Identification and assessment women at high fracture risk is effective in improving care of osteoporosis.