Dr. Marcy Bolster discusses the vital role of rheumatologists in managing Osteoporosis and the importance of bone health. Topics include early diagnosis through fracture liaison services, personalized treatment plans for different patient groups, and the impact of osteoporosis on overall well-being. The conversation also covers the challenges in selecting treatment options, identifying fracture risks in osteopenia patients, and improving osteoporosis care post-fracture.
Rheumatologists play a crucial role in managing bone health in patients with rheumatic diseases.
Educating patients on osteoporosis and treatment options is crucial for informed decision-making.
Screening for osteoporosis involves considering risk factors like glucocorticoid use, inflammatory disorders, and age.
Treatment decisions in osteoporosis are collaborative and tailored to each patient's needs and preferences.
Deep dives
Rheumatologists' Role in Preventing Osteoporosis
Rheumatologists play a crucial role in managing bone health, especially in patients with rheumatic diseases. Patients on glucocorticoids are at risk of bone loss and should have their bone health addressed. Osteoporosis, often silent, can lead to disability and fractures, making early intervention essential. By integrating bone health management into patient care, rheumatologists can provide comprehensive support.
Developing Interest in Osteoporosis
Interest in osteoporosis stemmed from its manageable nature and the ability to educate and engage with patients effectively. Understanding familial experiences with osteoporosis can also shape practitioners' dedication to addressing bone health. Embracing the challenge of learning and teaching about osteoporosis can lead to proactive patient care.
Assessing Patients for Osteoporosis
Screening patients for osteoporosis involves considering risk factors like glucocorticoid use, inflammatory disorders, and age. The decision to order a DEXA scan is individualized, taking into account factors like previous fractures, steroid use, and inflammatory conditions. In premenopausal women and men over 50, assessing fracture risk guides the need for bone density testing.
Treatment Approaches in Osteoporosis
Treatment decisions in osteoporosis are collaborative and tailored to each patient's needs and preferences. Oral bisphosphonates like alendronate are commonly prescribed but may face adherence challenges. Anabolic agents, such as PTH analogs or romosozumab, are considered for patients with severe osteoporosis or multiple fractures. Patient education on treatment benefits and risks is essential in shared decision-making.
Enhancing Patient Education and Engagement
Educating patients on osteoporosis, treatment options, and potential side effects is crucial for informed decision-making. Discussing common and rare medication side effects, such as esophageal discomfort or jaw osteonecrosis, enhances patient understanding. Encouraging lifestyle modifications like weight-bearing exercises and dietary calcium intake fosters proactive bone health management.
Role of a Fracture Liaison Service
A fracture liaison service bridges the gap between inpatient fracture care and outpatient osteoporosis management. By ensuring seamless treatment initiation post-fracture, the service significantly improves treatment rates and patient outcomes. Early identification of osteoporosis post-fracture and proactive intervention are key focus areas for improving bone health care.
Future Directions in Osteoporosis Care
The future of osteoporosis care emphasizes early patient identification and primary prevention strategies. Continuous research into new medications and treatment approaches targets enhanced patient outcomes. Advancing understanding of drug holidays, anabolic windows, and dental health considerations will shape more personalized and effective osteoporosis management.
Resources for Enhanced Patient Care
Accessing resources from organizations like the Bone Health and Osteoporosis Foundation, the International Osteoporosis Foundation, and professional societies like ACR can aid in improving osteoporosis knowledge and patient care. Guidelines, reviews, and patient education materials provide valuable support for rheumatologists looking to enhance bone health management in their practice.
Bone health may not be first on the mind when discussing rheumatology, however, Dr. Marcy Bolster believes it plays a vital role in caring for ‘the whole patient’. As such, Dr. Bolster’s innovative contributions to the field of Osteoporosis cannot be overstated. She joins us today to discuss the role of the rheumatologist in helping to prevent or treat Osteoporosis, how often it’s under-recognized, plus the services she created to help identify, diagnose and treat the condition among patients.
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