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For further access please register or login. Already have an account, click here to sign in. You are here: Orthopaedics. Osteoporosis: risk assessment, management and prevention This article offers a comprehensive overview of osteoporosis and the role of nurses in its diagnosis and management.
A summary of the main recommendations is provided below, adapted where appropriate for use in the UK. Teriparatide has been shown to reduce vertebral and non-vertebral fractures in postmenopausal women with osteoporosis [ 97 ]. Without clarity of the system of evidence that is used, guidelines users cannot decide whether recommendations are built on strong evidence or weak evidence. Drug treatment to reduce fracture risk Drugs that can be prescribed to prevent fragility fractures include bisphosphonates alendronate, ibandronate, risedronate and zoledronic acid and non-bisphosphonates raloxifene, denosumab, teriparatide, calcitriol and hormone replacement therapy. Our search was systematic and comprehensive including all the general databases, guideline websites and major guideline developer groups, and by hand searching the references of all identified guidelines. Improvement evident but still necessary in clinical practice guideline quality: a systematic review.
Reproduced with permission from McCloskey et al. Osteoporosis International 26 8 , —9. Drugs that can be prescribed to prevent fragility fractures include bisphosphonates alendronate, ibandronate, risedronate and zoledronic acid and non-bisphosphonates raloxifene, denosumab, teriparatide, calcitriol and hormone replacement therapy.
Full details of the licensed indications for these drugs can be found in the summary of product characteristics. At the time of publication April , not all bisphosphonate and non-bisphosphonate drugs have UK marketing authorisation for preventing osteoporosis. The prescriber should follow relevant professional guidance, taking full responsibility for the decision to prescribe an unlicensed medicine. Informed consent should be obtained and documented. See the General Medical Council's Prescribing guidance: prescribing unlicensed medicines for further information.
Guidance on treatment to prevent fragility fractures has been focused on treating post-menopausal women, because of their increased risk. Clinicians should ensure that other populations who might benefit from recommended treatments are also considered. Quality standard Tools and resources History Overview.
Quality statements Quality statement 1: Assessment of fragility fracture risk Quality statement 2: Starting drug treatment Quality statement 3: Adverse effects and adherence to treatment Quality statement 4: Long-term follow-up Update information About this quality standard.
Next Quality statement 2: Starting drug treatment Quality statement Rationale Quality measures What the quality statement means for different audiences Source guidance Definitions of terms used in this quality statement Equality and diversity considerations. Quality statement 2: Starting drug treatment Quality statement Adults at high risk of fragility fracture are offered drug treatment to reduce fracture risk.
Rationale Fragility fractures can cause substantial pain and severe disability, often leading to a reduced quality of life and sometimes to decreased life expectancy.
Quality measures Structure Evidence of local arrangements to ensure that adults at high risk of fragility fracture are offered drug treatment to reduce fracture risk. Process Proportion of adults at high risk of fragility fracture receiving drug treatment to reduce fracture risk.
The diagnosis of osteoporosis is based on patient and select the appropriate treatment follow-up (grade A. Osteoporosis|Osteoporosis is a preventable disease. Clinical Guidelines for Prevention, Diagnosis, and Management. Editors: Sarah H.
Numerator — the number in the denominator who receive drug treatment to reduce fracture risk. Denominator — the number of adults at high risk of fragility fracture. Outcomes a Incidence of fragility fractures.
What the quality statement means for different audiences Service providers general practices and secondary care services ensure that systems are in place for adults at high risk of fragility fracture to be offered drug treatment to reduce fracture risk. Source guidance Clinical guideline for the prevention and treatment of osteoporosis National Osteoporosis Guideline Group, section 6 and section 11, recommendation 7 Osteoporosis — prevention of fragility fractures NICE clinical knowledge summary.
mygaytrip.com/map.php Definitions of terms used in this quality statement At high risk of fragility fracture Women with a prior fragility fracture particularly hip or vertebral fracture and men and women with a year probability of a major osteoporotic fracture derived from FRAX, above the upper assessment threshold, should be considered for treatment see table 1.