Know Your Guidelines – Osteoporosis

Andrea Eberly, MD, MS, FAAEMGuideline Knowledge Check, Internal Medicine, Medical News

Internal Medicine Guidelines Knowledge Check on Osteoporosis

Stay in step with current national guidelines with Med-Challenger Guideline Knowledge Checks.

Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Internal Medicine Editor-in-Chief, Paul F. Griner, MD, MACP.

Based on the 2017 recommendations of the clinical guidelines committee of the American College of Physicians (ACP) …

… is estrogen now more strongly recommended for treating post-menopausal osteoporosis as compared to the last (2008) ACP osteoporosis guideline?

Yes or No?

The following case presentation provides the opportunity to apply the 2017 recommendations. Try this review question and find out if you’re following the most current guidelines.

Guideline Review Question

A 64-year-old woman suffers an inter-trochanteric fracture of the right hip from a fall. She undergoes a right hip replacement and has an uneventful recovery. A bone density test is subsequently performed and shows generalized osteoporosis.

The American College of Physicians (ACP) publishes practice guidelines for a variety of patient conditions that internists manage. These recommendations are based on a systematic review of randomized controlled trials, comprehensive reviews, large observational studies, and case reports for rare events.

Which one of the following correctly reflects the ACP recommendations in their 2017 clinical practice guideline update for the treatment of osteoporosis?

Offer recently post-menopausal women with documented osteoporosis treatment with estrogen.

Offer women with documented osteoporosis treatment with bisphosphonates or denosumab to reduce the risk of fractures.

Monitor bone density not only before and after but also during the pharmacologic treatment period of osteoporosis.

Pharmacological treatment of osteoporotic women is recommended to last a minimum of 3 years.

Answer Explanation & References:

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About Guideline Knowledge Checks:

With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.

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About the Author:

Paul Griner MD, MACP graduated from the University of Rochester School of Medicine and completed his residency at the Massachusetts General Hospital, Boston, MA. He returned to Rochester as Chief Resident in Medicine and Hematology Fellow and remained in their Department of Medicine, rising to Professor. He served as a Senior Lecturer at Harvard Medical School and consultant at the Massachusetts General Hospital where he introduced a mentoring program for the faculty of General Internal Medicine.

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