29th April 2011
Who to screen for osteoporosis, who treat for osteoporosis
Who to screen for osteoporosis
Age and weight is as good as any other tool!
http://therapeuticseducation.org/podcast/episode-121-atraumatic-way-break-down-evidence-around-bone-density-measurements
https://docs.google.com/viewer?url=http%3A%2F%2Fwww.acfp.ca%2Fdocs11%2FTFP44ScreeningforOsteoporosis.pdf
https://docs.google.com/viewer?url=http%3A%2F%2Fwww.acfp.ca%2Fdocs11%2FTFP44ScreeningforOsteoporosis.pdf
Who to treat
First who wants to be treated!
- 2% absolute risk reduction for primary prevention (98% no benefit)
- 6% absolute risk reduction for secondary prevention (92% no benefit)
If they do - they maybe can't do math ... but if they do
Age - Weight (kg)If greater than minus 5, increased risk of osteoporosis and BMD is warranted (A cut-off of greater than positive 5 should be used for Asian patients)So lets stop looking at the guidelines!
Once you do the test at 65 everyone has either Osteopenia or Osteoporosis unless they are over 100kg
Lets use some common sense
If everyone in the family has had a # under age 60 lets look into it but otherwise lets use Age - Weight (kg) but only if people are happy to take a tablet every day for 5 years and have a 98% of no benefit!
If we do it looks like we have some significant savings available in terms of ... everything!
