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  • Conley, Robert B.Center for Medical Technology Policy (author)

Secondary Fracture Prevention : Consensus Clinical Recommendations from a Multistakeholder Coalition

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • 2020
  • 17 s.

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:402adee6-67f8-4bcc-add2-ec7e98977e60
  • https://lup.lub.lu.se/record/402adee6-67f8-4bcc-add2-ec7e98977e60URI
  • https://doi.org/10.1097/NOR.0000000000000672DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Osteoporosis-related fractures are undertreated, due in part to misinformation about recommended approaches to patient care and discrepancies among treatment guidelines. To help bridge this gap and improve patient outcomes, the American Society for Bone and Mineral Research assembled a multistakeholder coalition to develop clinical recommendations for the optimal prevention of secondary fracture among people aged 65 years and older with a hip or vertebral fracture. The coalition developed 13 recommendations (7 primary and 6 secondary) strongly supported by the empirical literature. The coalition recommends increased communication with patients regarding fracture risk, mortality and morbidity outcomes, and fracture risk reduction. Risk assessment (including fall history) should occur at regular intervals with referral to physical and/or occupational therapy as appropriate. Oral, intravenous, and subcutaneous pharmacotherapies are efficacious and can reduce risk offuture fracture. Patients need education, however, about the benefits and risks of both treatment and not receiving treatment. Oral bisphosphonates alendronate and risedronate are first-line options and are generally well tolerated; otherwise, intravenous zoledronic acid and subcutaneous denosumab can be considered. Anabolic agents are expensive but may be beneficial for selected patients at high risk. Optimal duration of pharmacotherapy is unknown but because the riskfor second fractures is highest in the early post-fracture period, prompt treatment is recommended. Adequate dietary or supplemental vitamin D and calcium intake should be assured. Individuals being treated for osteoporosis should be reevaluated for fracture risk routinely, including via patient education about osteoporosis and fractures and monitoring foradverse treatment effects. Patients should be strongly encouraged to avoid tobacco, consume alcohol in moderation at most, and engage in regular exercise and fall prevention strategies. Finally, referral to endocrinologists or other osteoporosis specialists may be warranted for individuals who experience repeated fracture or bone loss and those with complicating comorbidities (eg, hyperparathyroidism, chronic kidney disease). (c) 2019 American Society for Bone and Mineral Research.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Adib, GemmaOsteoporosis Centre (author)
  • Adler, Robert A.Veterans Health Administration (author)
  • Åkesson, Kristina E.Lund University,Lunds universitet,Ortopedi - klinisk och molekylär osteoporosforskning,Forskargrupper vid Lunds universitet,Orthopedics - Clinical and Molecular Osteoporosis Research,Lund University Research Groups(Swepub:lu)orto-kak (author)
  • Alexander, Ivy M.University of Connecticut (author)
  • Amenta, Kelly C.Mercyhurst University (author)
  • Blank, Robert D.Garvan Institute of Medical Research,Medical College of Wisconsin (author)
  • Brox, William TimothyUniversity of California, San Francisco (author)
  • Carmody, Emily E.University of Rochester (author)
  • Chapman-Novakofski, KarenUniversity of Illinois at Urbana-Champaign (author)
  • Clarke, Bart L.Mayo Clinic Minnesota (author)
  • Cody, Kathleen M.American Bone Health (author)
  • Cooper, CyrusUniversity of Southampton (author)
  • Crandall, Carolyn J.University of California, Los Angeles (author)
  • Dirschl, Douglas R.University of Chicago Medical Center (author)
  • Eagen, Thomas J.National Council on Aging (author)
  • Elderkin, Ann L.American Society for Bone and Mineral Research (author)
  • Fujita, MasakiInternational Osteoporosis Foundation, Switzerland (author)
  • Greenspan, Susan L.University of Pittsburgh (author)
  • Halbout, PhilippeInternational Osteoporosis Foundation, Switzerland (author)
  • Hochberg, Marc C.Slotervaart Hospital (author)
  • Javaid, MuhammadUniversity of Oxford (author)
  • Jeray, Kyle J.Greenville Hospital System (author)
  • Kearns, Ann E.Mayo Clinic Minnesota (author)
  • King, TobyUnited States Bone and Joint Initiative (USBJI) (author)
  • Koinis, Thomas F.Duke Primary Care Oxford (author)
  • Koontz, Jennifer ScottNewton Medical Center,University of Kansas School of Medicine (author)
  • Kužma, MartinUniversity Hospital in Bratislava (author)
  • Lindsey, CarleenBristol Physical Therapy, LLC (author)
  • Lorentzon, MattiasSahlgrenska Academy,Sahlgrenska University Hospital,Australian Catholic University (author)
  • Lyritis, George P.Hellenic Osteoporosis Foundation (author)
  • Michaud, Laura BoehnkeUniversity of Texas (author)
  • Miciano, ArmandoNevada Rehabilitation Institute (author)
  • Morin, Suzanne N.McGill University (author)
  • Mujahid, NadiaBrown University (author)
  • Napoli, NicolaUniversity Campus Bio-Medico,Washington University in St. Louis (author)
  • Olenginski, Thomas P.Geisinger Health System (author)
  • Puzas, J. EdwardUniversity of Rochester (author)
  • Rizou, StavroulaHellenic Osteoporosis Foundation (author)
  • Rosen, Clifford J.Maine Medical Center Research Institute,Tufts University School of Medicine (author)
  • Saag, KennethUniversity of Alabama (author)
  • Thompson, ElizabethNational Osteoporosis Foundation (author)
  • Tosi, Laura L.Children’s National Health System, Washington (author)
  • Tracer, HowardAgency for Healthcare Research and Quality (author)
  • Khosla, SundeepMayo Clinic Minnesota (author)
  • Kiel, Douglas P.Harvard Medical School (author)
  • Center for Medical Technology PolicyOsteoporosis Centre (creator_code:org_t)

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