Healthcare professionals, public and patients in Iran have benefited from the many impactful outreach and educational activities carried out by the Endocrinology and Metabolism Research Institute (EMRI) in Iran. A long-time member of IOF’s Committee of National Societies, EMRI has collaborated extensively with IOF, held numerous IOF Osteoporosis Essentials Training Courses, translated many of IOF’s educational resources into Persian, and held multiple World Osteoporosis Day events in 2019. 

Prof. Jean-Yves Reginster, Chair of the IOF Committee of National Societies, commented:

“IOF congratulates EMRI for their outstanding commitment to osteoporosis and fracture prevention, their exemplary engagement in IOF programmes and projects, and impressive research activities. EMRI has been among the most active member organizations in the IOF Committee of National Societies since 2004 - we are proud to have such as high-profile organization within our global network.”

A brief outline of the events and activities of 2019-2020 to date, in the areas of healthcare professional education, research, post-fracture care, and public awareness:

Healthcare Professional Education 
An Annual symposium of Osteoporosis was held by EMRI in collaboration with the NCDs Department of the Ministry of Health and Medicine on October 24th 2019. About 500 HCPs from all provinces of the country and across a wide variety of disciplines, participated in the symposium. The latest updates on risk factors, diagnosis, treatments, follow-up, and rehabilitation in osteoporosis and fragility fracture were presented by prominent lecturers of Tehran University of Medical Sciences. 

EMRI also organized 10  IOF-ISCD Osteoporosis Essentials courses in 2019-2020, focusing on specific educational zones in Iran. Two out of 10 courses were held in Tehran and Shiraz, and, unfortunately due to the Covid-19 crises, two courses planned in Mashhad (27-28 February), and Ahwaz (14-15 April) will be rescheduled.

EMRI members have actively participated at all WCO-IOF-ESCEO World Congresses, an important global platform to present Iranian medical research in the bone field. Most recently, 15 abstracts were submitted, of which two were selected for oral presentation and the remaining accepted for poster presentation. 

Research Activities
Guidelines: Work is ongoing on updated ‘Comprehensive Clinical Guidance for early detection, diagnosis, treatment and control of Osteoporosis’ in collaboration with Ministry of Health. All related protocols have been reviewed and several meetings have taken place with the experts in different fields related to osteoporosis.

Point of care solution for the risk assessment of osteoporosis:
EMRI has collaborated with European partners as part of the European Union’s Horizon 2020 Framework Program (H2020-NMBP) in developing a device for early stage detection of osteoporosis and to prevent secondary fracture. The Institute is now developing a pre-analytical variable model to conduct clinical validation of the instrument. Furthermore, a clinical study has been initiated so far in which the data of 400 patients are extracted. The patients will be followed up for four years.

Iranian Multicenter Osteoporosis Study (IMOS):  

Researchers at EMRI will conduct the new round of the IMOS study in 2020, including almost 2500 participants aged over 50 years, from 6 provinces that are nationally representative of Iranian population. The protocol has been developed and finalized. The questionnaire was developed and validated and a software was designed for online data entry. All infrastructure and logistics are ready and BMD collaborating centers were trained specifically. The study is ready to go, and will commence once the Covid-19 crisis has abated. 

Post-Fracture Care:

There is growing interest in Fracture Liaison Services (FLS). With Capture The Fracture® guidance, a national guideline has been prepared and software was developed accordingly.

A training workshop was held for centres that are candidates for establishing FLS. Already, two centers have been established in Gorgan and Sari provincial cities, and the hope is that a third center will be established in Tehran in the near future.

Public Education:

Every year, EMRI holds dynamic World Osteoporosis Day activities (for which IOF resources are translated into Persian) and yearlong community capacity building to raise awareness of osteoporosis prevention and control throughout the country and among the population at risk. 

Beginning in June 2019 a nation-wide campaign was planned in collaboration with the Non-communicable Diseases (NCDs) Department of Ministry of Health and Medical Education (MOH & ME). The aim: To increase public awareness of osteoporosis and the importance of early diagnosis and treatment to prevent the occurrence of fragility fracture. Targeting women aged ≥50 years old, the motto was “Prevent the consequence of osteoporosis with early detection and effective treatment”.

Educational materials were prepared with the collaboration of NCDs and Health Promotion departments of the Ministry of Health and Medical Education. The campaign was conducted in the Women’s’ Health Week (Oct. 29th-Nov. 4th), which aligns with World Osteoporosis Day around October 20th. The Universities of Medical Sciences and Health services were responsible to conduct the campaign in their defined populations.

The following activities were carried out during the campaign:
•    Billboards and electronic boards in public places in the urban area 
•    Stands and banners in governmental offices and public places 
•    Official letters to inform about campaign and mottos on official letters issued during the campaign 
•    Education programs on provincial TV channels and media
•    Personal interviews with doctors on radio and TV with related subjects (about 100 interviews across the country).
•    Educational articles on newspapers and magazines
•    Holding seminars, webinars and CME courses for doctors and health care providers by medical universities 
•    Training sessions for religious community leaders and their pupils
•    Educational sessions in schools and universities for students 
•    Distribution of educational material through social media
•    Distribution of educational tracts and pamphlets (about 40000)
•    Holding sport and social events for promoting physical activity and its preventive effect on osteoporosis