To the Editor: With regard to the Clinical Practice article on postmenopausal osteoporosis by Walker and Shane (Nov. 23 issue),¹ we believe that one additional topic merits emphasis — the systemic underuse of evidence-based antiosteoporosis medications after fragility fracture. This divergence between guideline recommendations and real-world practice is termed the “osteoporosis care gap.” Less than 30% of patients receive antiosteoporosis treatments after a fragility fracture in the United States.² This care gap decreases quality of life and increases the risks of a subsequent fracture, rehospitalization, future institutionalization, and death. It also costs U.S. health systems billions of dollars annually.³ Drivers . . .

致编辑：关于 Walker 和 Shane 撰写的关于绝经后骨质疏松症的临床实践文章（11 月 23 日）¹ ，我们认为还有一个值得强调的主题——脆性骨折后循证抗骨质疏松药物的系统性使用不足。指南建议与现实世界实践之间的这种差异被称为“骨质疏松症护理差距”。在美国，只有不到 30% 的患者在发生脆性骨折后接受抗骨质疏松治疗。²这种护理差距会降低生活质量，并增加随后骨折、再住院、未来住院治疗和死亡的风险。美国卫生系统每年还为此花费数十亿美元。³司机。 。 。