Talk with your patients about osteoporosis

Many people don’t know they have osteoporosis until they suffer a fracture. That’s why it’s important to maintain ongoing conversations with your older patients about the risks of falls and the benefits of osteoporosis screening.

Starting the conversation

• Proactively evaluate the risk of falls with older patients at each office visit:
• Ask your patients if they’ve fallen or had issues with balance and walking.
• As appropriate, suggest:
• A cane or walker
• An exercise program
• Vision testing
• Assess the potential causes such as medications.
• Consider the need for vitamin D supplementation.

• For women age 65 and older, reinforce the importance of screening for osteoporosis with bone mineral density testing. This test is the only one that can diagnose osteoporosis.

• For women age 67 and over who’ve already incurred a fracture, order a bone mineral density test and prescribe an osteoporosis medication within six months of the fracture. Do this unless BMD testing was done within two years of the fracture or osteoporosis treatment has occurred 12 months before the fracture.

Checking on osteoporosis care
HEDIS^®* star measures, including the Health Outcomes Survey, evaluate osteoporosis care and the risk of falls.

• HEDIS measures:
• The Osteoporosis Management in Women Who Had a Fracture Measure. This measure assesses the percentage of women age 67 and older who had a bone mineral density test or treatment for osteoporosis within six months of a fracture.
• Patients who had bone mineral density testing two years prior to a fracture or osteoporosis treatment 12 months before the fracture are excluded.
  
  
• The Risk of Falls measure assesses the percentage of members 65 and older who:
• Were seen by a practitioner in the past 12 months.
• Discussed falls or problems with balance or walking with their current provider.

• The Health Outcomes Survey asks patients:
• Have you ever had a bone mineral density test to check for osteoporosis?
• Has your doctor discussed the risk of falls, how to prevent falls or treat problems with balance or walking?

For more information
The U.S. Preventive Services Task Force webpage on osteoporosis indicates that doctors should screen all women age 65 and older for osteoporosis.

The American College of Physicians published evidenced-based osteoporosis treatment guidelines in the Annals of Internal Medicine on May 9, 2017. The group recommends that doctors offer pharmacologic therapy to reduce the risk for hip and vertebral fractures in women with known osteoporosis.

You can also check out the Centers for Disease Control and Prevention’s Older Adult Falls webpage.

HEDIS^® is a registered trademark of the National Committee for Quality Assurance.