Incorporation of a patient navigator into a secondary fracture prevention program identifies barriers to patient care.

Incorporation of a patient navigator into a secondary fracture prevention program identifies barriers to patient care. Aging Clin Exp Res. 2020 Feb 07;: Authors: Jia KQ, Southerland L, Phieffer L, Stephens JA, Ing SW Abstract INTRODUCTION: Patient navigation improves outcomes in various clinical contexts, but has not been evaluated in secondary fracture prevention. METHODS: We retrospectively reviewed charts of patients, age 50 + from April to October, 2016 hospitalized with fragility fracture contacted by a patient navigator. Patients were identified using an electronic tool extracting data from electronic medical records which alerted the patient navigator to contact patients by phone post-discharge to schedule appointments to "High-Risk Osteoporosis Clinic" (HiROC) and Dual-energy X-ray Absorptiometry (DXA) scan. Primary outcome was transition from hospital to HiROC. We also compared completion of DXA, five osteoporosis-associated in-hospital laboratory tests (calcium, 25-hydroxy vitamin D, complete blood count, renal, and liver function), osteoporosis medication prescription and adherence, and other patient characteristics to historical controls (2014-2015) without patient navigation. Comparisons were made using Chi-square, Fisher's Exact, two-sample t test or Wilcoxon Rank Sum test, as appropriate. RESULTS: The proportion of patients transitioning to HiROC with and without patient navigation was not different (53% v...
Source: Aging Clinical and Experimental Research - Category: Geriatrics Authors: Tags: Aging Clin Exp Res Source Type: research

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Current evidence suggests that dual-energy X-ray absorptiometry (DXA) scans, the conventional method defining osteoporosis, is underutilized and, when used, may underestimate patient risk for skeletal fragility. It has recently been suggested that other imaging modalities may better estimate bone quality, such as the magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score which also may assess vertebral compression fracture risk in patients with spine metastases.
Source: The Spine Journal - Category: Orthopaedics Authors: Source Type: research
Authors: Kang MY, Besley J, Sun T, Paul S Abstract BACKGROUND: Little is known about the prevalence of renal impairment in patients presenting with osteoporotic fractures contraindicating bisphosphonate use in New Zealand, and their eligibility to denosumab. AIM: To assess the prevalence of renal impairment contraindicating bisphosphonate use in older adults presenting with osteoporotic fractures, differences in demographic variables between those with renal impairment and those who do not, and finally to assess eligibility for denosumab based on the current PHARMAC special authority criteria. METHOD: All p...
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
AbstractThe surgeon general of the USA defines osteoporosis as “a skeletal disorder characterized by compromised bone strength, predisposing to an increased risk of fracture.” Measuring bone strength,Biomechanical Computed Tomography analysis  (BCT), namely, finite element analysis of a patient’s clinical-resolution computed tomography (CT) scan, is now available in the USA as a Medicare screening benefit for osteoporosis diagnostic testing. Helping to address under-diagnosis of osteoporosis, BCT can be applied “opportunistically” to most existing CT scans that include the spine or hip re...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Abstract Osteoporosis is characterised by low bone mineral density (BMD) and is a significant public health problem in India. This cross-sectional study was done to assess the relationship between various anthropometric measures and BMD in 308 rural dwelling South Indian postmenopausal women. Anthropometric variables such as weight, body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured. BMD was assessed by dual-energy X-ray absorptiometry (DXA) scan at the lumbar spine (LS) and femoral neck (NOF). The mean age ± SD of study participan...
Source: Tropical Doctor - Category: Tropical Medicine Authors: Tags: Trop Doct Source Type: research
Conclusions: As NaF PET/CT becomes more popular in evaluating skeletal calcium metabolism (as shown by the measurement of osteoporosis), advancing technology such as total-body PET/CT scanners should be used to take complete advantage of this imaging modality. We believe that future, well-powered studies are needed to prove this prediction, and detail the far-reaching benefits today-body PET/CT scanners can have for osteoporotic patients.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Educational Exhibits Poster Session I Source Type: research
46Objectives: Traditionally, obesity is believed to be protective against osteoporosis. However, recent accumulating evidences suggest that visceral obesity increases the risk of osteoporosis and obesity-driven dysfunctional metabolic activity in visceral adipose tissue (VAT) is considered as a possible underlying mechanism for the development of obesity-related osteoporosis. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to assess the degree of VAT metabolic activity. We aimed to investigate the predictive role of VAT metabolic activity evaluated by 18F-FD...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Spotlights in Endocrinology Source Type: research
Conclusion2D SSAM can dramatically improve hip fracture prediction at high specificity levels and estimate the year of the impending fracture using standard clinical images. This has the potential to be implemented in clinical practice to estimate hip fracture risk.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
AbstractSummaryIn a global survey of fracture liaison services, most reported that DXA access met needs. However, adherence to basic DXA quality and reporting procedures was confirmed by only around 50% of institutions and many required education for operators/interpreters. Overall, there is significant variability in the access to, and quality of, DXA services worldwide.IntroductionWhile the use of dual-energy X-ray absorptiometry (DXA) has been widely adopted worldwide for the assessment of bone mineral density, the quality of DXA facilities is unknown. To address this, a global survey of fracture liaison services (FLS) ...
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
Osteoporosis is an age-associated disease characterised by low bone mineral density (BMD) and micro-architectural deterioration leading to enhanced fracture risk. Conventional dual-energy X-ray absorptiometry (DXA) analysis has facilitated our understanding of BMD reduction in specific regions of interest (ROIs) within the femur, but cannot resolve spatial BMD patterns nor reflect age-related changes in bone microarchitecture due to its inherent averaging of pixel BMD values into large ROIs. To address these limitations and develop a comprehensive model of involutional bone loss, this paper presents a fully automatic pipel...
Source: IEE Transactions on Medical Imaging - Category: Biomedical Engineering Source Type: research
Excess adiposity in childhood may affect bone development, ultimately leading to bone frailty. Previous reports showing an increased rate of extremity fractures in children with obesity support this fear. On the other hand, there is also evidence suggesting that bone mineral content is higher in obese children than in normal weight peers. Both adipocytes and osteoblasts derive from multipotent mesenchymal stem cells (MSCs) and obesity drives the differentiation of MSCs toward adipocytes at the expense of osteoblast differentiation. Furthermore, adipocytes in bone marrow microenvironment release a number of pro-inflammatory...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
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