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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

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:fe76189c-cdd8-4927-a624-a356c0d920a8
  • https://lup.lub.lu.se/record/fe76189c-cdd8-4927-a624-a356c0d920a8URI
  • https://doi.org/10.1097/BOT.0000000000001743DOI

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 fractureamong 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, andsubcutaneous pharmacotherapies are efficaciousandcanreduce risk of future fracture.Patientsneededucation,however, about thebenefitsandrisks 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 butmay be beneficial for selected patients at high risk.Optimal duration of pharmacotherapy is unknown but because the risk for second fractures is highest in the earlypost-fractureperiod,prompt treatment is recommended.Adequate dietary or supplemental vitaminDand calciumintake shouldbe assured. Individuals beingtreatedfor osteoporosis shouldbe reevaluated for fracture risk routinely, includingvia patienteducationabout osteoporosisandfracturesandmonitoringfor adverse treatment effects.Patients shouldbestronglyencouraged to avoid tobacco, consume alcohol inmoderation atmost, 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).

Subject headings and genre

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

  • Adib, GemmaOsteoporosis Centre, Damascus (author)
  • Adler, Robert A.Hunter Holmes McGuire VA Medical Center (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,Skåne University Hospital(Swepub:lu)orto-kak (author)
  • Alexander, Ivy M.University of Connecticut (author)
  • Amenta, Kelly C.Mercyhurst University (author)
  • Blank, Robert D.Medical College of Wisconsin,Garvan Institute of Medical Research (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 (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.Baltimore Veterans Administration Medical Center,University of Maryland (author)
  • Javaid, MuhammadUniversity of Oxford (author)
  • Jeray, Kyle J.Prisma Health (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 ScottUniversity of Kansas,Newton Medical Center (author)
  • Kužma, MartinUniversity Hospital in Bratislava (author)
  • Lindsey, CarleenBristol Physical Therapy, LLC (author)
  • Lorentzon, MattiasUniversity of Gothenburg,Sahlgrenska University Hospital,Australian Catholic University (author)
  • Lyritis, George P.Hellenic Osteoporosis Foundation (author)
  • Michaud, Laura BoehnkeUniversity of Texas MD Anderson Cancer Center (author)
  • Miciano, ArmandoNevada Rehabilitation Institute (author)
  • Morin, Suzanne N.McGill University (author)
  • Mujahid, NadiaBrown University (author)
  • Napoli, NicolaSapienza University of Rome,Washington University in St. Louis (author)
  • Olenginski, Thomas P.Geisinger Health System (author)
  • Puzas, J. EdwardUniversity of Rochester Medical Center (author)
  • Rizou, StavroulaHellenic Osteoporosis Foundation (author)
  • Rosen, Clifford J.Maine Medical Center Research Institute,Tufts University (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 University (author)
  • Center for Medical Technology PolicyOsteoporosis Centre, Damascus (creator_code:org_t)

Related titles

  • In:Journal of Orthopaedic Trauma34:4, s. 125-1410890-5339

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