CPD 105: OSTEOPOROSIS Continuing Professional Development
CPD
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AUTHORS: Fellow Emeritus, Professor Moira O’Brien, FRCPI, FFSEM, FFSEM(UK), FECSS, FTCD. Consultant in osteoporosis and Sports Medicine since the 70s and osteoporosis since 1990 when she set up the first osteoporosis clinic in the anatomy department of TCD. Founder and President of the Irish Osteoporosis Society. She is currently the only Osteoporosis consultant in Ireland and works in Affidea Dundrum. Michele O’Brien, CEO of the Irish Osteoporosis Society. Michele set up the first Falls Prevention service for senior citizens in Ireland in 2000 and has worked for the IOS Charity for 23 years.
60 Second Summary Osteoporosis is the most common bone disease worldwide. The Irish Osteoporosis Society (IOS) have been saying for decades that it affects all age groups and both sexes. Bone loss is treatable in the majority of cases, yet more men die from the complications of osteoporotic fractures than cancer of the prostate, and men have a higher risk of morbidity and mortality than women. Osteoporosis is a silent disease, there are no signs and symptoms, no one feels bone loss. The commonest cause is low levels of sex hormones, oestrogen in women and testosterone in men. Osteoporosis and osteopenia are both diseases and should be thoroughly investigated, Osteopenia should not be considered “A touch of bone loss”. The effect of medication on the prevention of fractures must be monitored closely to ensure the treatment plan is working and improve compliance. Lifestyle, exercise, stress, diet, sleep are important factors to assess. Effective and safe medications are available to treat osteopenia/Osteporosis. Most medications can cause possible side effects, but the benefits to bone health by preventing future fractures usually far outweighs the possible risks. It is rarely too late to investigate and treat a patient with bone loss, even those in their 90’s with Dowagers humps.
1. REFLECT - Before reading this module, consider the following: Will this clinical area be relevant to my practice?
knowledge gap - will this article satisfy those needs - or will more reading be required?
2. IDENTIFY - If the answer is no, I may still be interested in the area but the article may not contribute towards my continuing professional development (CPD). If the answer is yes, I should identify any knowledge gaps in the clinical area.
4. EVALUATE - Did this article meet my learning needs - and how has my practise changed as a result?Have I identified further learning needs?
3. PLAN - If I have identified a
5. WHAT NEXT - At this time you may like to record your learning for future use or assessment. Follow the
4 previous steps, log and record your findings. Published by HPN. Copies can be downloaded from www.irishpharmacytraining.ie Disclaimer: All material published is copyright, no part of this can be used in any other publication without permission of the publishers and author.
Osteoporosis, what you need to know Introduction Osteoporosis is the most common bone disease worldwide, it is a silent disease, as there are no signs and symptoms. There is a significant amount of misinformation and myths about osteoporosis, both in the public and Healthcare domain. For example, the Irish Osteoporosis Society (IOS) have been saying for decades that it affects all age groups and both sexes, yet most believe it only affects old women. Findings from a recent survey by Athena Pharmaceuticals found that one in five adults have fractured a bone since they turned 40, over a third of these people reported to have had a fragility fracture and the rate of these low impact fractures was high amongst 40 to 54 year olds. Prevention ideally should start in childhood, which is why physical activity should be mandatory in all schools and integrated into the school curriculum, as not only does it help to prevent Osteoporosis but obesity and a list of other diseases.
More men die from the complications of osteoporotic fractures than cancer of the prostate and men have a higher risk of morbidity and mortality than women. More women are affected, and more women die from the complications of osteoporotic fractures, than the combined deaths from cancers of the breast, ovaries, and cervix. Now that you have picked your jaw up from the floor, these are some of the many reasons why all health care professionals need to review their knowledge on Osteoporosis, so the prevention, diagnosis and treatment rates can be improved, and why fragility fractures in those under 65 should have bone loss ruled out, as the cost of treating fractures will double by 2030. Osteoporosis is characterised by low bone density, abnormal changes in the microarchitecture of bone tissue, particularly cancellous bone, making it more fragile, with an increased risk of low trauma fractures. It is essential to find the cause/s of bone loss and modify
as many risk factors as possible going forward. The commonest bones to fracture are the cancellous part of the distal radius, the body of the vertebrae or the hip (neck of femur) and vertebrae but any bone can be affected. A low trauma fracture (trip and fall from a standing height or less) is usually the first sign of this silent disease, along with loss of height, postural changes such as their head protruding forward, rounded shoulders and/or a Dowagers hump developing. It is estimated that up to 500,000 people in Ireland may have osteoporosis and that over 50,000 osteoporotic fractures occur each year in Ireland. 1 in 2 women and 1 in 4 men over 65, will develop an osteoporotic fracture in their lifetime, if it is not prevented. Younger people will develop osteopenia and/or osteoporosis if they have risk factors for bone loss, which is why in an ideal world any patient being put on a new medication or diagnosed with a new condition should be red flagged if either place them at risk for bone loss, so a plan can be
