Continuing Medical Education (CME)

Osteoporosis Prevention and Treatment
[2002 update, 2005 revision]

Introduction to this self-study CME activity

Purpose

Osteoporosis and associated fractures are significant public health issues that are expected to become more important as the population of the United States ages. Fortunately, there are effective strategies for prevention and treatment. The purpose of this educational activity is to help clinicians Decrease osteoporotic fractures and their associated morbidity and mortality through preventive treatment and the diagnosis and treatment of low bone mass. Key points include:

• Recommend weight bearing exercise and adequate calcium and vitamin D for all persons
• Order first DEXA scan based on clinical risk factors, including:
    -Postmenopausal woman and one or more of the following:
        -Age > 65 years
        -Personal history of fracture without substantial trauma age > 40 years
        -Hip, wrist, or spine fracture without substantial trauma in 1st degree relative > 50 years
        -Current smoking
        -Low body weight
        -Frailty (inability to rise from a chair unassisted)
    -Prednisone 7.5 mg or more daily for 6 months or longer
    -Other medications and medical conditions
• Treat based on DEXA t-score and clinical risk factors for fracture:
    -Prior osteoporosis-related fracture
    -T-score <-1 postmenopausal at high risk (above)
    -T-score <-1 and glucocorticoid use
    -T-score <-2 in most other situations
• For most patients, an interval of at least 2 years between DEXA scans provides the most meaningful information.

Audience

This self-study activity is appropriate for primary care clinicians and other health care providers who diagnosis and treat adults, particularly postmenopausal women and persons at risk for secondary osteoporosis related to long-term glucocorticoid use, organ transplant, or other medical conditions.

Authors

Team Leader
	Jane McCort, MD General Medicine
Team Members
	Van Harrison, PhD Medical Education Robert Lash, MD Endocrinology Yolanda Smith, MD Obstetrics/Gynecology Lourdes Velez, MD Family Medicine
Author Disclosures
	Team Member Company Relationship Van Harrison, PhD (None) Robert Lash, MD (None)   Jane McCort, MD (None)   Yolanda Smith, MD Eli Lilly, Forest, Abbott, Wyeth, GlaxoSmithKlein Research grant   Pfizer Consultant Lourdes Velez, MD (None)

Other Acknowledgements

UMHS Guidelines Oversight Team: William E. Chavey, MD R. Van Harrison, PhD Connie J. Standiford, MD Literature search services: Taubman Medical Library Production of Internet format and web site maintenance: Ellen Patrick-Dunlavey, MA

CME Accreditation and Credit Designation

The University of Michigan Medical School is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Michigan Medical School designates this educational activity for a maximum of 1 AMA/PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was released in July 2005, with credit available through June 2008. The activity was reviewed for currency of content in July 2008 and availability of credit extended through June 2009. The activity was reviewed for currency of content in June 2009 and availability of credit extended through June 2010.

Method of Participation

1. View the web pages. You may print the self-study text to read off-line.
2. Complete the on-line learning assessment test.  It will be electronically scored and the correct answers returned immediately for your review.
3. Complete the electronic credit request and activity evaluation.  An electronic certificate of participation will be provided immediately.
4. Print the certificate of participation for your personal records.

 

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