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New guide on osteoporosis treatment, prevention offered.

THE NATIONAL Osteoporosis Foundation has released a new clinician's guide to help U.S. health care providers make the best treatment decisions and better predict those at risk for fractures.

The Clinician's Guide to Prevention and Treatment of Osteoporosis, released in late February, goes beyond the traditional guidelines and includes advice for black, Asian, Hispanic and other women as well as men ages 50 and older. Osteoporosis is a major public health problem that can lead to chronic pain, disability and even death. Each year broken bones due to low bone mass or osteoporosis cause more than 432,000 hospital admissions, almost 2.5 million medical office visits and about 180,000 nursing home admissions, according to statistics from the National Osteoporosis Foundation.

The new clinician's guide "dramatically alters the approach to assessing fracture risk and treatment," said Bess Dawson-Hughes, chair of the guide's development committee and past president of the National Osteoporosis Foundation. "The guide provides evidence-based recommendations to help health care providers better identify people at risk for developing osteoporosis and fractures and assures that those at highest risk are recommended for treatment to lower that risk."

Among those recommendations is a recently released algorithm on "absolute fracture," which is also referred to as a 10-year fracture model and 10-year fracture probability. It estimates the likelihood of a person breaking a bone due to low bone mass or osteoporosis over a 10-year period.

Absolute fracture risk methodology provides an improved method to assure that people with highest fracture risk get treated, according to the guide. Those at greatest risk of fracture include postmenopausal women and older men with a diagnosis of osteoporosis or those with a clinical diagnosis based on having sustained a spine or hip fracture. Absolute fracture risk calculations also help resolve many questions about management for people living with low bone mass, or osteopenia.

The algorithm used in the guide takes into account not only bone mineral density but also nine specific clinical risk factors for osteoporosis and related fractures.

"To be able to better identify and treat those patients at risk for osteoporosis and costly fractures will have a positive impact on the medical, emotional and economic burden that osteoporosis bears on this country," said Ethel Siris, MD, president of the National Osteoporosis Foundation.

The osteoporosis guide also provides recommendations for clinicians on when to perform bone mineral density testing, lists risk factors for falls and gives universal recommendations for osteoporosis prevention. Those universal recommendations are summarized in five steps to bone health: get the daily recommended amounts of calcium and vitamin D, engage in regular weight-bearing and muscle-strengthening exercise, avoid smoking and excessive alcohol consumption, talk to a health care provider about bone health and have a bone density test and take medication when appropriate. The guide recommends adults older than 50 get 1,200 mg of daily calcium and 800 to 1,000 IU of vitamin D.

The guide was developed by an expert National Osteoporosis Committee in collaboration with a multi-specialty council of medical experts in the field of bone health.

The full guide as well as other information on osteoporosis is available at Clinicians_Guide.htm.
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Publication:The Nation's Health
Date:Jun 1, 2008
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