Albert van de Wiel

Albert van de Wiel studied medicine at the University Utrecht and specialized in Internal Medicine. He worked at De Lichtenberg Hospital, Amersfoort, tje Academic Hospital Utrecht. His PhD was about Immunoglobulin A and alcoholic liver disease. He was Senior consultant Internal Medicine at the Meander Medical Centre, Amersfoort with focus on metabolic disorders and vascular medicine. In the same centre he was head of the department of Internal Medicine, Head Central Training Committee and the Advisory Board Science and Research. Currently he is professor at the TU Delft, chair Clinical Medicine and Isotopes for Health at the Dept. Radiation Science and Technology, Faculty of Applied Sciences. He is initiator and Board Adviser at Medworq.

PRESENTATION

Healthy Bones (Gezonde Botten) improving osteoporosis care and fracture prevention

At the time of the CBO consensus “osteoporosis and fracture prevention” in 2011, the incidence of fractures in the Netherlands was more than 80.000 per year with around 800.000 individuals having an increased fracture risk. These numbers are much higher now and will further increase the coming years mainly because of an aging population.

Fractures cause morbidity, sometimes permanent limitations in mobility, admissions to hospitals, nursing homes and rehabilitation centers and are associated with an increased mortality, up to 25% within a year after a hip fracture in the elderly over 80 years. More than 60% of elderly patients will remain handicapped after a hip fracture and fractures are a real threat for staying autonomous as long as possible.

Estimations of the costs associated with fractures vary depending on the calculation model used; the total direct medical costs of 65+ patients, visiting emergency rooms in the Netherlands with a fracture amounted to 780 million euro’s in 2013. Costs for society do now exceed a billion euro’s per year.

The intention of the Healthy Bones Program is to improve the care for elderly patients with a high fracture risk and to reduce fractures in the near future. The program identifies patients at high risk (FIND), provides care in relation to the patients risk profile (GUIDE) and encourages self-management by the patient (HOME). With e-health tools and data management the program allows a uniform, certified treatment according to the consensus of physician’s organizations not depending on the type of medical discipline. The program also provides adequate data for scientific research and assessments. The ambition is to provide better preventive care for more people without exceptional costs.