How A Holistic Approach Helps with Management of Osteoporosis?

Sometimes referred to as the “silent thief”, individuals often do not know they have osteoporosis (OP) until a fracture happens. OP is a condition that causes bones to become weak and more fragile, making them more susceptible to breaking [1]. OP affects millions of people around the world, particularly women over the age of 50. The etiology of osteoporotic fractures is complex and involves multiple factors. Overall, as people age, the risk of fractures increases [2]. Fractures place an enormous personal and medical burden on individuals. Chronic pain, deformity, disability, loss of independence, and reduced quality of life, and significant functional limitations are a few to note [3]. Literature shows a major advancement in techniques for diagnosis of OP, and numerous drug choices for treatment [4]. However, there is still a lack of a holistic approach to help further understand the overall health and well-being of those who are affected by the condition. A holistic approach would take into account not only the biological and biochemical factors, but also psychological (emotional), and social aspects that contribute to the condition. In general, this approach considers the full picture of the condition that affects not only the body but also the mind and spirit and addresses all aspects of the individual’s health and well-being. Several studies have demonstrated that people with OP experience anxiety, depression, and social isolation, which can affect their quality of life and make it more challenging to manage the condition effectively. Evidence shows that a holistic care plan can be influential, especially in diminishing fear-avoidance of initiating actions and compliance with the management of the condition over time [3]. Hence, a whole picture of this condition may involve a comprehensive evaluation of the person’s medical history, lifestyle, diet, education, socioeconomic factors, and current state of physical and mental functioning. Such a procedure can facilitate decisionmaking about what support, treatment, and care is needed based on a person’s circumstances, needs, and preferences.

A holistic personalized care plan can be developed by including diagnoses, clinical manifestations, the severity of symptoms, cognitive and mental status, as well as individuals’ needs and preferences. So, now it makes sense to say that a holistic approach for OP is not limited to medication adherence, because it also involves addressing the underlying psychological and social factors that contribute to the development and progression of the condition. To achieve this, the International Classification of Functioning, Diseases and Health (ICF) is a framework for describing the level of function of a person within their unique environment or what a person with a specific condition can do based on their level of capacity. Developed by the World Health Organization, this framework approaches patient care to understand the spectrum of problems in the functioning of a persons with a specific condition, and places focus on the interrelations between a person, their environment, and their everyday functioning. The central philosophy of this holistic model is to provide a unified standard language for describing a health condition and its interplay with several personal and environmental layers that impact the individual. The development of the ICF framework beyond diagnosis was an attempt to increase awareness of the consequences of a chronic condition upon individuals. This framework was developed as a practical tool to facilitate the systematic and comprehensive description of functioning in clinical practice [5].

A person with OP requires comprehensive care and interdisciplinary interventions consisting of programs oriented toward their specific needs and preferences. Using the ICF framework can lead to a more holistic and comprehensive assessment and management of any patient with OP. The ICF is a functional model, rather than a solely diagnosis-basis model, for greater awareness of the impact of the OP condition on a person’s life [2]. By focusing on the physical, emotional, and social factors contributing to the condition, healthcare providers can create individualized treatment plans that address all aspects of the person’s health and overall quality of life.

In short, taking an evidence-based practice to patient care requires healthcare providers’ attention to their patients’ holistic needs and preferences and the restrictions that OP places on what they could actually do [1].

A holistic approach can be helpful to frame assessment and management strategies that are more comprehensive for persons with OP since this condition can be experienced differently through nuanced and highly individualized contextual factors. Healthcare providers must prioritize rehabilitation for OP and ensure that patients have access to high-quality holistic rehabilitation services to manage their condition effectively. The ICF framework can potentially improve multidisciplinary, holistic, clinical care through structured examination, comprehensive care plan, and a common language for communication. Using the ICF as the guiding framework for assessing and managing OP may enhance interprofessional education and care, ensuring that important patient outcomes are met. Approaching OP from this broader perspective can broaden our understanding of the condition and facilitate the development of decision-making about meaningful care plans for individuals. From a holistic perspective, management of OP based on treating the whole person-mind, body and spirit can be more effective than typical traditional approaches because it provides numerous benefits that improve their overall bone health and wellbeing.

Azar Varahra is the only author who contributed to this editorial.

The author reports no conflict of interest.

1. A Varahra, IB Rodrigues, JC MacDermid, D Bryant, T Birmingham, et al. (2018) “Exercise to improve functional outcomes in persons with osteoporosis: a systematic review and meta-analysis,” Osteoporos. Int 29(2): 265-286.
2. C Ziebart, AD Page, JC MacDermid (2020) “Application of ICF conceptual framework in Osteoporosis,” Physiother. Theory Pract 36(10): 1077-1087.
3. AE Bombak, HM Hanson (2016) “Qualitative Insights from the Osteoporosis Research: A Narrative Review of the Literature,” J. Osteoporos 2016: 7915041.
4. JC Gallagher (2018) “Advances in osteoporosis from 1970 to 2018,” 25(12): 1403-1417.
5. A Rauch, A Cieza, G Stucki (2008) “How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice,” 44(3): 329-342.