• Revenue Cycle Management
  • COVID-19
  • Reimbursement
  • Diabetes Awareness Month
  • Risk Management
  • Patient Retention
  • Staffing
  • Medical Economics® 100th Anniversary
  • Coding and documentation
  • Business of Endocrinology
  • Telehealth
  • Physicians Financial News
  • Cybersecurity
  • Cardiovascular Clinical Consult
  • Locum Tenens, brought to you by LocumLife®
  • Weight Management
  • Business of Women's Health
  • Practice Efficiency
  • Finance and Wealth
  • EHRs
  • Remote Patient Monitoring
  • Sponsored Webinars
  • Medical Technology
  • Billing and collections
  • Acute Pain Management
  • Exclusive Content
  • Value-based Care
  • Business of Pediatrics
  • Concierge Medicine 2.0 by Castle Connolly Private Health Partners
  • Practice Growth
  • Concierge Medicine
  • Business of Cardiology
  • Implementing the Topcon Ocular Telehealth Platform
  • Malpractice
  • Influenza
  • Sexual Health
  • Chronic Conditions
  • Technology
  • Legal and Policy
  • Money
  • Opinion
  • Vaccines
  • Practice Management
  • Patient Relations
  • Careers

Clinical guidelines for the diagnosis and treatment of osteoporosis

Article

The latest recommendations from the Institute for Clinical Systems Improvement

The aging of the population is expected to increase the frequency, cost, and burden of fractures associated with age-related bone loss. Guidelines on prevention, screening, diagnosis, and treatment of osteoporosis are available from several organizations.

In July, 2013, the Institute for Clinical Systems Improvement (ICSI) released an update to its Health Care Guideline for the Diagnosis

and Treatment of Osteoporosis (Available at: https://www.icsi.org/guidelines_more/).

This is the eighth edition of the evidence-based guideline. For the first time, ICSI used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.

The guideline group considered systematic reviews and randomized controlled trials published between January, 2010 and January, 2013, that evaluated frequency of dual-energy X-ray absorptiometry (DXA), primary and secondary workups, fracture risk assessment (FRAX), calcium as it pertains to cardiovascular risk, osteoporosis in men, vitamin D, and denosumab.

The guideline focuses on adults only and discusses prevention, diagnosis and treatment. To achieve these aims, the guideline provides two recommendations:

  • Clinicians should discuss risk factors for osteoporosis and primary prevention with all patients presenting for preventive/wellness health visits, and

  • address options for prevention and treatment of osteoporosis, including pharmacologic intervention if appropriate, and engage the patient in shared decision-making to facilitate discussions on treatment options.

Screening

Screening is recommended for osteoporosis in women aged 65 years and older and in younger women whose fracture risk by FRAX analysis is ≥9.3 percent or who are considered to be at fracture risk.

Male risks

The guidelines recommend identifying men in whom bone mineral density measurement is justified. They include men 70 years and older or aged 50-69 years and who, based on risk factor profile, are deemed as being at sufficiently high risk for low bone mass and future fracture

Estrogen therapy

Estrogen therapy is not recommended as a first-line agent for prevention or management of osteoporosis and should be used for preventing postmenopausal osteoporosis only in women at significant risk who cannot take non-estrogen therapies.

Other updates

Other updates pertain to recommendations for dietary/supplement intake of calcium and vitamin D, duration of bisphosphonate therapy and drug holidays, data on denosumab treatment frequency and safety, and the frequency of follow-up DXA testing.

Related Videos
Robert E. Oshel, PhD
Gary Price, MD, MBA
Victor J. Dzau, MD, gives expert advice
Ron Holder, MHA, gives expert advice
remote patient monitoring
referral
no shows
effective meetings
phone
© 2023 MJH Life Sciences

All rights reserved.