COSA Risk Assessment Tool Deployed Across Community Pharmacies to Identify Undiagnosed Patients

HONG KONG SAR - Media OutReach Newswire - 23 July 2026 - The Department of Pharmacology and Pharmacy, LKS Faculty of Medicine , the University of Hong Kong (HKUMed) today announced the launch of Hong Kong's first structured community pharmacist-led osteoporosis screening programme, built upon the validated Chinese Osteoporosis Screening Algorithm (COSA). The initiative enables trained community pharmacists to proactively identify individuals at high risk of osteoporosis — a condition that affects millions yet remains widely undiagnosed — and to facilitate timely referral to family physicians for clinical evaluation, bone mineral density assessment, and diagnosis, thereby helping hidden patients in community to receive appropriate care. Despite being one of the most prevalent bone diseases in Hong Kong, osteoporosis is estimated to go undiagnosed and untreated in up to 80% of those affected, largely because the disease is asymptomatic until a fracture occurs. By embedding screening within the familiar and accessible setting of community pharmacies, this programme represents a significant step forward in closing the gap between disease burden and clinical intervention. Osteoporosis Can Lead to Fragility Fractures with Mortality Rates Comparable to Major Cancers Osteoporosis affects approximately 30% of women and 8% of men aged over 50 or above in Hong Kong, causing progressive deterioration of bone density that leaves patients vulnerable to fragility fractures — fractures that occur from low-impact forces such as a minor fall or even a sudden movement. These fractures carry consequences far beyond physical injury. Research demonstrates that the one-year mortality rate following a hip fracture can exceed that of certain common cancers, including prostate and breast cancer. Local hospital data further indicate that nearly half of all patients who sustain a fragility hip fracture do not survive beyond five years. Despite these grave outcomes, public awareness remains alarmingly low: international studies suggest that fewer than one in ten at-risk individuals proactively seek a bone mineral density assessment. Community Pharmacies as an integral part of Primary Healthcare with Pharmacists Playing a Key Role Recognising the urgent need for a scalable, community-based approach to osteoporosis detection, community pharmacies are increasingly recognised as one of the vital platforms for screening and health education. Community pharmacies play a unique position in the primary healthcare ecosystem — they are among the most frequently visited and trusted healthcare touchpoints in daily life, offering not only medication dispensing but also accessible health consultations, disease prevention education, risk assessments, and referrals, serving as a critical component of the primary healthcare ecosystem. Standardising the COSA Screening Process to Reach High-Risk Individuals in the Community Since 2026, the Department of Pharmacology and Pharmacy at HKUMed has collaborated with multiple community pharmacies to introduce a standardised osteoporosis risk assessment protocol into the community, enabling specially trained community pharmacists to utilise the COSA tool to screen high-risk individuals. The assessment requires only four data points — sex, age, body weight, and prior fracture history — and can be completed within minutes during a routine pharmacy visit. Pharmacists trained in the protocol explain results to patients immediately upon completion. Individuals identified as high-risk receive a written referral to a family physician or other healthcare professionals for further evaluation, including Dual-energy X-ray Absorptiometry (DXA) scanning to confirm diagnosis. All participants, regardless of risk classification, receive bone health education, including guidance on calcium and vitamin D intake, balanced diets, appropriate weight-bearing exercise, fall prevention, and other lifestyle modifications. Studies have demonstrated that these non-pharmacological interventions independently reduce fracture incidence, offering bone protection even in the absence of drug therapy. Promising Early Results: Approximately 60% of High-Risk Individuals Willing to Undergo...