Implementation of Osteoporosis Screening in Hong Kong: Perspectives of Healthcare Providers Through the Lens of the Consolidated Framework for Implementation Research
Author(s)
Chenwen Zhong, PhD1, Junjie Huang, PhD2, Martin Chi Sang Wong, MD2.
1JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong, 2The Chinese University of Hong Kong, Hong Kong, Hong Kong.
1JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong, 2The Chinese University of Hong Kong, Hong Kong, Hong Kong.
OBJECTIVES: Osteoporosis is a significant public health issue in Hong Kong, particularly with its aging population, high prevalence, and severe outcomes such as fractures and disability. Despite its recognized importance, osteoporosis screening remains underutilized. This study examines the barriers and facilitators to osteoporosis screening from healthcare providers’ perspectives.
METHODS: In-depth interviews were conducted with 17 healthcare providers from various settings, including private practice, NGOs, District Health Centres (DHCs), Community Health Centres (CHCs), public healthcare settings, and post-fracture rehabilitation specialists. Participants had 3 to over 10 years of experience. Thematic analysis, guided by the Consolidated Framework for Implementation Research (CFIR), was used to identify key barriers and facilitators.
RESULTS: Key barriers identified included a lack of an integrated screening system, long waiting times for DXA scans in the public sector, and financial constraints in the private sector, with screening largely patient-funded (reported by 9 private-sector doctors). Time pressures in public healthcare (with over 40 patients daily) were another obstacle, as well as patient perceptions that osteoporosis is a natural aging process, reducing screening demand. Facilitators included recommendations to standardize screening guidelines, integrate screening into government-subsidized programs, and improve education. Collaboration between NGOs, DHCs, and private providers, along with the establishment of specialized osteoporosis clinics, were also suggested as ways to enhance screening access and efficiency.
CONCLUSIONS: Financial, time, and resource limitations hinder osteoporosis screening adoption in Hong Kong. To improve uptake, screening should be integrated into government-supported healthcare programs, public awareness should be raised, and cross-sector collaboration should be fostered. A structured referral system and clear treatment pathways are necessary to overcome existing barriers and improve patient outcomes.
METHODS: In-depth interviews were conducted with 17 healthcare providers from various settings, including private practice, NGOs, District Health Centres (DHCs), Community Health Centres (CHCs), public healthcare settings, and post-fracture rehabilitation specialists. Participants had 3 to over 10 years of experience. Thematic analysis, guided by the Consolidated Framework for Implementation Research (CFIR), was used to identify key barriers and facilitators.
RESULTS: Key barriers identified included a lack of an integrated screening system, long waiting times for DXA scans in the public sector, and financial constraints in the private sector, with screening largely patient-funded (reported by 9 private-sector doctors). Time pressures in public healthcare (with over 40 patients daily) were another obstacle, as well as patient perceptions that osteoporosis is a natural aging process, reducing screening demand. Facilitators included recommendations to standardize screening guidelines, integrate screening into government-subsidized programs, and improve education. Collaboration between NGOs, DHCs, and private providers, along with the establishment of specialized osteoporosis clinics, were also suggested as ways to enhance screening access and efficiency.
CONCLUSIONS: Financial, time, and resource limitations hinder osteoporosis screening adoption in Hong Kong. To improve uptake, screening should be integrated into government-supported healthcare programs, public awareness should be raised, and cross-sector collaboration should be fostered. A structured referral system and clear treatment pathways are necessary to overcome existing barriers and improve patient outcomes.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD192
Topic Subcategory
Distributed Data & Research Networks
Disease
SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)