Osteoporosis

Objectives

1. Assess osteoporosis risk of all adult patients as part of their periodic health examination.
2. Use bone mineral density testing judiciously (e.g., don’t test everybody, follow a guideline).
3. Counsel all patients about primary prevention of osteoporosis (i.e., dietary calcium, physical activity, smoking cessation), especially those at higher risk (e.g., young female athletes, patients with eating disorders).
4. In menopausal or peri-menopausal women, provide advice about fracture prevention that includes improving their physical fitness, reducing alcohol, smoking cessation, risks of physical abuse, and environmental factors that may contribute to falls (e.g., don’t stop at suggesting calcium and vitamin D).
5. In patients with osteoporosis, avoid prescribing medications that may increase the risk of falls.
6. Provide advice and counseling about fracture prevention to older men, as they too are at risk for osteoporosis.
7. Treat patients with established osteoporosis regardless of their gender (e.g., use bisphosphonates in men).