HKUMed takes leading role in the largest cohort study on global hip fracture burden

The Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong (HKUMed), is pleased to announce the launch of a novel multinational research study on the global burden of hip fractures. The research project, commenced on July 1, 2020 and continues through June 2022, will be the largest cohort study on hip fracture, involving 19 countries/territories across the world.

Global burden of hip fracture
Osteoporosis is considered a silent disease because it could be asymptomatic while hip fracture is the most devastating clinical outcome of osteoporosis. Hip fracture is recognised as one of the major public health burdens, especially among the elderly population, that poses a significant burden on one’s mobility and morbidity, which in turn increases the risk of mortality. With the rapidly ageing population, it is expected to affect more than 4.5 million people by the year 20501. According to the Department’s recent projection, there will be more than 2.5 million hip fractures occurring each year in Asia by 2050, amongst which around 27,000 hip fractures will occur in Hong Kong2.

Cross-geographical comparison of hip fracture studies can provide insights on etiology, risk factors, and impact of healthcare practices. However, the lack of standardised methodology for the studies hampered the direct comparison between different demographics. The research team, therefore, launched this global hip fracture burden study, aiming to fill the gap for cross-geographical comparison. This will be the largest cohort study on hip fracture, involving 19 countries/territories from Asia, Oceania, North and South America, and Western and Northern Europe. Large electronic healthcare databases, covering over 400 million patients worldwide, will be used to examine the incidence, treatment rate, and mortality of hip fracture.

Policy and public health implications
The use of big data approach increases the generalisability of the study findings and thus provides reliable evidence in healthcare resource management and policymaking. Through this large multi-national study, the research team hopes to have a better understanding of the impact of demographic variation on hip fracture, thus providing evidence for the world to tailor-make public health-related policy in addressing the disease burden.

Pharmacological treatment in preventing hip fracture is critically under-used globally, mainly due to patients’ worries on rare yet severe side effects. A previous study led by the research team has shown that less than 20% of patients had received anti-osteoporosis medication in the first year after hip fracture in Hong Kong[3]. Given the proven efficacy of pharmacological treatment, it is important to raise the awareness of using the medications. This study will compare the treatment rate and mortality of patients across the countries/territories which could investigate the importance of pharmacological treatment.

Professor Ian Wong Chi-kei, Lo Shiu Kwan Kan Po Ling Professorship in Pharmacy, Professor and Head of the Department of Pharmacology and Pharmacy, HKUMed, remarked, “This project would be the largest collaborative study of hip fracture. It is essential to raise public awareness on the severity of hip fractures and provide support for strategic policy making in the management of ageing population.”

Professor Alfonso Ngan Hing-wan, Acting Vice-President and Pro-Vice-Chancellor (Research), Kingboard Professor in Material Engineering and Chair Professor in Materials Science and Engineering, HKU commented, “Big data research is a strategic research area of HKU, I am pleased to say this major funding is the testimony of our ability and capacity of world leading healthcare big data research.”

The Global Hip Fracture project is coordinated by the Department of Pharmacology and Pharmacy, HKUMed, with the support of a US$1.67M (HK$13M) funding from the Amgen Inc., one of the world-leading biopharmaceutical companies. The research in Hong Kong is led by Professor Ian Wong Chi-kei, Lo Shiu Kwan Kan Po Ling Professorship in Pharmacy, Professor and Head of Department of Pharmacology and Pharmacy, and Dr Cheung Ching-Lung, Assistant Professor of the Department, HKUMed.

About the Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, HKU (HKUMed)
The Department is a renowned interdisciplinary research hub on various areas, with research interests spanning from basic pharmacology research on cardiovascular, ageing and related disease, to big data research on medication use and delivery. With world-leading research in metabolic pharmacology, the Department has made significant contributions through its research and its commitment to the concept of knowledge exchange. The Department has also been one of the leading centres in osteoporosis research and has recently published in high profile journals, including JAMAThe Lancet, and Annals of Internal Medicine, demonstrating the Department’s advocacy for high-quality research output. Past research has also informed both international and local public health policies.