Student-Led Osteoporosis Risk Assessment to Prevent Fractures in Community Setting: Design and Development
Conference
Levitt, Eli, Khan, Irfan, Weingart, Amelia et al. Student-Led Osteoporosis Risk Assessment to Prevent Fractures in Community Setting: Design and Development
. 10.13140/RG.2.2.19239.29605
Levitt, Eli, Khan, Irfan, Weingart, Amelia et al. Student-Led Osteoporosis Risk Assessment to Prevent Fractures in Community Setting: Design and Development
. 10.13140/RG.2.2.19239.29605
The United States has a growing elderly population with an increasing prevalence of osteoporosis. Osteoporosis can lead to osteoporotic fractures, which are associated with substantial morbidity, including impaired ambulation and loss of independence, and mortality. In patients who sustain osteoporotic hip fractures, 21-30% of them pass away within one year. The financial burden of osteoporotic fractures is also significant, with nearly $50 billion and $754 million dollars being spent every year in the U.S. on non-fatal and fatal falls, respectively. According to the CDC - 500 Cities Project, only 18.2% of adult females 65 years and older received recommended preventive services. Objective: To describe a new partnership between two student-led groups to increase the use of recommended preventive services for the prevention and management of osteoporosis in a community setting. Methods: The approach, based on current United States Preventive Services Task Force (USPSTF) clinical guidelines and expert opinion,1,2,4 must be guided by the individual participant’s medical history, access to care, and other social determinants. All individuals who attend a health event in a community setting at a park or farmer’s market would be eligible for participation. Population: - Women 65 years and older - Post-menopausal women under 65 - Men over 65, who may not otherwise receive screening for osteopenia and osteoporosis Intervention: Patients will receive risk factor assessment and personalized education including fracture risk factors and healthy lifestyle habits to maintain good bone health. Resources: The publically available Fracture Risk Assessment (FRAX) tool will be used to calculate the ten-year risk of major osteoporotic fractures and hip fractures (Figure 1). Discussion: This project examines current screening guidelines for osteoporosis, identifies an approach to assess the risk of participants developing osteoporotic fractures, and highlights areas for future research. Reducing the frequency and complications of fractures is multifactorial, and while preventing osteoporosis is the most effective strategy, neuromuscular training and coordination/balance training are important factors that need to be considered, especially in elderly individuals.3 The main outcome of this pre-implementation project was the development of an evidence based approach to identify individuals at risk for fracture and provide personalized recommendations based on ability to access healthcare, and connect patients with continual, sustainable care. The approach is based on using calculations from the FRAX tool to identify high-risk individuals who would benefit from shared decision-making and further clinical evaluation (Figure 1). Individuals who decide to seek additional care will be informed about their follow-up options (Figure 3). The majority of reviewed literature focuses on women, with studies including men being inconclusive on whether they should be included in Osteoporosis Screening.1 More studies are needed that evaluate the direct effect of screening for osteoporosis on fracture outcomes. Further research is needed to demonstrate the effectiveness of this intervention protocol targeted toward individuals in a community setting. The student-led initiative for osteoporosis risk assessment to prevent osteoporotic fractures in the local community is set to begin in January 2020.
