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Purpose, Audience, Authors, and Acknowledgements
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.
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.
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Team Leader |
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Jane McCort, MD
General Medicine |
Team Members |
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Van Harrison, PhD
Medical Education
Robert Lash, MD
Endocrinology
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Yolanda Smith, MD
Obstetrics/Gynecology
Lourdes Velez, MD
Family Medicine
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Author Disclosures |
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| Team Member |
Company |
Relationship |
| Van Harrison, PhD |
(None)
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| Robert Lash, MD |
(None) |
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| Jane McCort, MD |
(None) |
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| Yolanda Smith, MD |
Eli Lilly, Forest, Abbott,
Wyeth, GlaxoSmithKlein
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Research grant
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Pfizer |
Consultant |
| Lourdes Velez, MD |
(None) |
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UMHS Guidelines Oversight Team: |
Connie Standiford, MD
Lee Green, MD, MPH
Van Harrison, PhD |
Literature search services: |
Taubman Medical Library |
Production of Internet format of guideline: |
Ellen Patrick-Dunlavey |
Web site design and maintenance: |
University of Michigan BMC Media |
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