Optimizing The Management of Osteoporosis Assignment Paper

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Optimizing The Management of Osteoporosis Assignment Paper

Response/Osteoporosis/ Health Conditions and Implications for Women

Primary Prevention

• Encouraging physical exercises: Research Studies show that the health benefits of exercise include reduced risk of falls and fractures. According to Pouresmaeili et al. (2018), muscle-strengthening and weight-bearing exercises are recommended for osteoporosis prevention as they improve balance, posture, agility and strength to prevent falls. Avoidance of alcohol consumption and cigarette smoking as they are harmful to bone health. The treatment education includes advising patients on increased intake of calcium and vitamin D. Oral bisphosphonates should not be taken in patients with active upper GI disease and should be taken before meals because the absorption is <1% with food or beverage. Optimizing The Management of Osteoporosis Assignment Paper

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Osteoporosis Introduction

Osteoporosis is a significant health problem characterized by low bone mass, porous bone and structural deterioration resulting in an increased risk of fractures. Osteoporotic fracture-related disability and chronic pain affect the function and quality of life (Lorentzon et al., 2021). The risk factors are classified as modifiable and non-modifiable. Modifiable risk factors include cigarette smoking, alcohol consumption, low BMI, inadequate physical activity and low dietary calcium intake. Non-modifiable risk factors include white race, family history, female sex and advanced age.

Osteoporosis Symptoms

Osteoporosis often goes undetected. Some visible signs include kyphosis, loss of height, and postural changes such as the dowager’s hump. Fractures mainly occur in the upper limb bones, ribs, vertebrae, hips, wrist and pelvis (Lorentzon et al., 2021). For some people, lifting something heavy or tripping over something is enough to cause the vertebrae to break. Optimizing The Management of Osteoporosis Assignment Paper

Screening

Screening for the disease may facilitate treatment before the occurrence of osteoporotic fractures. Most guidelines recommend DXA screening for women >65 years. DXA measures report the t-score and z-score. The t-score shows the difference between the measured bone mineral density and the mean value of bone mineral density. WHO developed the osteoporosis risk assessment tool and gives a ten-year probability of a major fracture (Goveia et al., 2022). It considers the independent risk factors, BMI, and some secondary osteoporosis causes. The fracture risk assessment tool also evaluates osteoporotic fracture risk probability.

Diagnostic Test

Liver, thyroid, and kidney function tests are essential to rule out secondary causes of osteoporosis. Bone densitometry checks whether the bone density is low (Wilson et al., 2020). The results of the BMD test are expressed as a T-score. A T-score <-2.5 is seen in patients with osteoporosis. DEXA assesses the bone mineral density of the spine and hips. Optimizing The Management of Osteoporosis Assignment Paper

Treatment

Drugs used for treatment are designed to increase the production of new bone or slow bone loss. Bisphosphonates are used as the first line of therapy and act by increasing the BMD of trabecular bones and are potent inhibitors of bone resorption (Farrah & Jawad, 2020). Examples of drugs under this class include alendronate. Receptor activator of nuclear factor-kappa B ligand medications such as denosumab favour bone formation over resorption and increases bone strength and mass in both the cortical and trabecular bone.

Primary Prevention and Education on Treatment

The primary prevention strategy includes advising patients to avoid modifiable risk factors such as alcohol consumption, cigarette smoking and supplementation of calcium and vitamin D. Lifestyle changes are also recommended for all patients (Wilson et al., 2020). Patients on treatment should be educated on the drug’s mode of action and the possible side effects. Patients are also educated on alternative medications in case the current treatment fails. Optimizing The Management of Osteoporosis Assignment Paper

Response 2

Osteoporosis causes impaired bone density and quality, increasing the fracture risk from a non-trivial fall, slip or even spontaneous. It has an enormous negative influence on an individual’s emotional, physical and mental well-being. According to Watts (2018), bone loss associated with declining estrogen levels increases the risk of fractures in postmenopausal women, who make up the majority of the cases.

Osteoporosis has no specific signs and symptoms unless there is a fracture. Typical manifestations are vertebrae fractures, distal radius and hip (Lorentzon et al., 2021). The healthcare provider should assess the factors associated with an increased risk of osteoporosis-related fracture, which includes smoking, alcohol consumption, steroid use, low BMI, inadequate physical activity and others.

Guidelines recommend that adults >50 years with a history of fractures have a BMD screening. The gold standard for diagnosing is DXA, especially in the lumbar spine and hip. The FRAX tool considers the risk factors to predict the 10-year probability of osteoporotic fractures (Goveia et al., 2022). Laboratory investigations such as liver function tests and thyroid hormone levels rule out secondary osteoporosis causes. Optimizing The Management of Osteoporosis Assignment Paper

The main goal of osteoporosis therapy is to reduce fracture risk. Pharmacological therapy such as bisphosphonates, hormonal replacement, anabolic agents and others is recommended in postmenopausal women with a history of hip or vertebral fracture and those with BMD consistent with osteoporosis. (Farrah & Jawad, 2020). Patients should be encouraged to adequate vitamin D and calcium intake, smoking cessation, weight-bearing exercises, fall prevention techniques and limitation of alcohol intake (Wilson et al., 2020). Treatment education includes the drug’s mode of action, interactions, possible side effects and follow-up advice.

Osteoporosis is a significant public health concern affecting millions of the ageing population. Early prevention helps reduce high morbidity. An interprofessional team of healthcare providers best manages the condition. Optimizing The Management of Osteoporosis Assignment Paper

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References

Farrah, Z., & Jawad, A. S. (2020). Optimizing the management of osteoporosis. Clinical Medicine, 20(5), e196–e201. https://doi.org/10.7861/clinmed.2020-0131

Goveia, M. R., Moraes, G. M. A., Tavares, M. A. de S. B., Santos, T. F. dos, Vasconcelos, L. G. de A., Miacava, M. L., Ribeiro, R. S., Castro, C. H. de, Stutz, L. G., Rodrigues Filho, J. N. dos S., Davalos, S. R. A., & Rodrigues, N. D. R. (2022). A literature review on osteoporosis risk factors and prevention: the importance of an early approach. Research, Society and Development, 11(1), e35411124606. https://doi.org/10.33448/rsd-v11i1.24606

Lorentzon, M., Johansson, H., Harvey, N. C., Liu, E., Vandenput, L., McCloskey, E. V., & Kanis, J. A. (2021). Osteoporosis and fractures in women: the burden of disease. Climacteric, 25(1), 1–7. https://doi.org/10.1080/13697137.2021.1951206

Pouresmaeili, F., Kamali Dehghan, B., Kamarehei, M., & Yong Meng, G. (2018). A comprehensive overview on osteoporosis and its risk factors. Therapeutics and Clinical Risk Management, 14(1), 2029–2049. https://doi.org/10.2147/tcrm.s138000

Watts, N. B. (2018). Postmenopausal Osteoporosis: A Clinical Review. Journal of Women’s Health, 27(9), 1093–1096. https://doi.org/10.1089/jwh.2017.6706

Wilson, A., Maiocco, G., & Sambamoorthi, U. (2020). Osteoporosis and Health-Related Quality of Life Among Older Women. Journal of Nursing Practice, 4(1), 70–83.  Optimizing The Management of Osteoporosis Assignment Paper