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CME: Postmenopausal osteoporosis risk stratification and treatment of those at high fracture risk

ACCREDITATION EXPIRED: August 20, 2024

Activity Description / Statement of Need:

In this online, self-learning activity:

Osteoporosis is a disease common among elderly patients and is increasing in frequency as senior citizens begin to represent a larger share of the US population. In the US, fragility fractures are associated with 1.7 million hospitalizations, and the number of annual of osteoporotic fractures is expected to rise to three million annually in the next few years, with annual treatment costs expected to be $25.3 billion. Despite the morbidity and mortality associated with osteoporosis, practice gaps related to suboptimal screening, risk assessment, and management practices have led to underdiagnosis and undertreatment of this condition. Osteoporosis screening may identify people at increased risk of low-trauma fracture who may benefit from interventions to minimize risk. The USPSTF recommends screening for osteoporosis with BMD testing in all women 65 years or older and in postmenopausal women younger than 65 years but at increased risk of osteoporosis. However, the literature has consistently illustrated underutilization of screening and diagnostic measures. About 60% of women for whom the USPSTF recommends screening do not receive BMD testing,  with some patient populations more likely than others to miss out on screening and care. Clinicians should be aware that prior fragility fracture is sufficient for diagnosis of osteoporosis, and yet only one-quarter of patients with a prior fragility fracture were aware they had this condition. Underdiagnosis therefore represents a compelling safety consideration, as 20% of patients become dependent on long-term care after a hip fracture, and 20% die within a year from related complications.

Target Audience:

HCPs specializing in: endocrinology, internal medicine, geriatrics, and women’s health; physician assistants, nurse practitioners, and pharmacists who practice in those areas of specialty; and those who otherwise commonly care for or clinically encounter patients with postmenopausal osteoporosis.


Commercial Support Disclosure: This program is supported by an educational grant from Radius Health.

This activity is free of charge.


Release Date: August 20, 2022 -- Expiration Date: August 20, 2024

Faculty: Braden Barnett, MD

Agenda

Faculty introduction, disclosures

Introduction content: defining the problem

  • Epidemiology
  • Risk factors for postmenopausal osteoporosis and fracture
  • Patient cases

Risk assessment and diagnosis

  • WHO Fracture Risk Algorithm (FRAX): applications and limitations
  • Imaging and biomarkers
  • Role of the healthcare team in community engagement with osteoporosis screening in postmenopausal women
  • Challenges in determining risk of fracture

Treatment and prevention of osteoporosis

  • Developments in evidence for use: clinical trial findings and guideline updates concerning treatments
    • Initial therapy, present treatment options, and their roles in management
      • Bisphosphonates – safety
      • RANKL inhibition
      • Parathyroid hormone-receptor agonists
      • Sclerostin inhibition
      • HRT/SERMs
    • Therapeutic considerations
      • Contraindications to bisphosphonates
      • Severe osteoporosis
      • Duration of therapy
    • Therapies to avoid
  • Additional therapeutic considerations
    • Patient-specific treatment considerations and special populations, including secondary prevention and chronic kidney disease
    • Controversies and risks
    • Optimizing adherence to therapy and patient education
  • Patient cases

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall how the results of diagnostic imaging and patient history determine fracture risk.
  • Describe risks and challenges associated with identifying fracture risk and treating patients with postmenopausal osteoporosis.
  • List the criteria for initiation of pharmacotherapy for postmenopausal osteoporosis treatment and fracture prevention.
  • Develop a plan to manage for a postmenopausal patient’s risk of osteoporotic fracture.
  • Identify present and emerging pharmacotherapeutic management strategies for mitigating fracture risk in postmenopausal osteoporosis.

Accreditation

ACCME Activity #202328651

ACCREDITATION FOR THIS COURSE HAS EXPIRED. YOU MAY VIEW THE PROGRAM, BUT CME / CE IS NO LONGER AVAILABLE AND NO CERTIFICATE WILL BE ISSUED.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Faculty Disclosure: Braden G. Barnett, MD, Clinical Assistant Professor of Medicine, Division of Endocrinology, University of Southern California, has received financial compensation from Dexcom and Kilo Health for consulting and/or speaker's bureau work.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will NOT discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Radius Health.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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