The Osteoporotic Vertebral Compression Fracture Patient: Prevention, Diagnosis, Why to Refer, and Treatment

Statement of Need / Program Overview

Often referred to as a “silent epidemic,” osteoporosis is a global problem that is growing in significance as the worldwide population increases and continues to age. It is a serious public health concern in terms of incidence, healthcare costs and complications associated with the disease. Osteoporosis is characterized by low bone mineral density (BMD) which consequently leads to an increased risk for fractures, most commonly of the hip, spine and wrist. The loss of bone mass and strength is typically asymptomatic, thus many individuals are not aware that they have osteoporosis until a fracture occurs. Although low BMD confers an increased risk for fracture, most fractures occur in postmenopausal women and elderly men at moderate risk. Occurrence of an initial fracture has been demonstrated to be a major risk factor for new fractures. Vertebral fractures can lead to back pain, loss of height, kyphosis, immobility, and may also have a profound impact on quality of life and activities of daily living. The goals of osteoporosis treatment are to reduce bone loss, prevent fractures, control pain, and prevent disability. Despite attempts to increase awareness of the magnitude and consequences of osteoporosis and recommendations for screening and treatment from multiple groups, the disease remains under-detected and under-treated in the United States. There is also a need to examine the current evidence on treatment efficacy and outcomes for all treatment options for VCFs in order to advise patients on appropriate therapy for their individual situation.

Agenda

Welcome
Jeanne M. Huddleston, MD

Lecture: Overview of Consensus Guidelines for Osteoporosis Screening for Patients Who Should Undergo BMD Screening
Jeanne M. Huddleston, MD

Lecture: Ensuring Correct Diagnosis of VCFs: Signs, Symptoms and Tests
Mark Dekutoski, MD

Discussion: Practical Tips for Prevention and Diagnosis
Moderator: Jeanne M. Huddleston, MD
Panel: All faculty

Discussion: Best Practices for Communication Between Healthcare Team Members for At-risk Osteoporosis Patients During Their Continuum of Care
Moderator: Mark Dekutoski, MD
Panel: All faculty

Lecture: Pharmacologic Treatments and Lifestyle Changes for Osteoporosis Prevention and Management
Ann E. Kearns, MD, PhD

Lecture: Interventional Treatment Options for Patients with VCFs: When to Refer, Treatment Options, and Outcomes
Jonathan M. Morris, MD

Discussion: Treatment Options
Moderator: Mark Dekutoski, MD
Panel: All faculty

Concluding Comments
Mark Dekutoski, MD

Media

Internet, video with slides.

Release Date: December 22, 2011
Expiration Date: December 21, 2012

Faculty

  • Mark B. Dekutoski, MD Co-Chair About

    Associate Professor, Dept. of Orthopaedics

    Mayo Clinic
    Rochester, MN

    Mark Dekutoski is Associate Professor of Orthopaedics at the Mayo Clinic, Rochester, MN. Dr. Dekutoski completed medical school and his residency training in general surgery and orthopaedic surgery at Wayne State University, Detroit, MI. He completed his fellowship at the Twin Cities Scoliosis Spine Center, University of Minnesota, Minneapolis, MN. Dr. Dekutoski is Board Certified. Today his practice is focused on adult and pediatric spinal deformity, spinal tumors, and degenerative disc disease.  Read More

  • Jeanne M. Huddleston, MD Co-Chair About

    Consultant, Department of Hospital Internal Medicine
    Assistant Professor of Medicine, College of Medicine

    Mayo Clinic
    Rochester, MN

    Read More

  • Ann E. Kearns, MD, PhD About

    Consultant, Division of Endocrinology
    Assistant Professor of Medicine, College of Medicine

    Mayo Clinic
    Rochester, MN

     

  • Jonathan M. Morris, MD About

    Assistant Professor of Radiology

    Mayo Clinic
    Rochester, MN

     

Target Audience

This activity has been designed to meet the educational needs of primary care physicians, hospitals, diagnostic radiologists, spine surgeons, oncologists, and pain management specialists.

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Interpret current consensus guidelines on screening for osteoporosis by identifying patients who should undergo BMD screening.
  • Outline how to identify patients at-risk for vertebral compression fractures (VCFs) and review relevant diagnostic steps.
  • Identify new opportunities for collaboration between healthcare team members to increase identification of patients at risk for osteoporosis and VCFs.
  • Outline current treatment options for osteoporosis prevention and treatment, including pharmacotherapy and lifestyle changes, with discussion of risks and benefits of each.
  • Evaluate interventional treatment options and their outcomes for patients with VCFs.

Course Completion Time

Based upon trials, the estimated time to complete this program is 1 hour.

Sponsorship

Jointly sponsored by Postgraduate Institute for Medicine and BroadWater.

Educational Grant

This activity is supported by an educational grant from Medtronic and Lilly, Inc.

Physician Accreditation

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and BroadWater, LLC. Postgraduate Institute for Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The Postgraduate Institute for Medicine designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Policy

Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity.

Faculty Disclosure

In accordance with U.S. Food and Drug Administration (FDA) and ACCME guidelines, the financial and significant relationships to this program are listed below.

Mark B. Dekutoski, MD has indicated the following relevant financial relationships: Royalty (self): Mayo Clinic, Medtronic; Receipt of intellectual property rights/patent holder (self): Mayo Clinic, Medtronic, Perc. Trauma; Consultant fees (self): AO Foundation, Perc. Trauma, Vertical Health LLC

Jeanne M. Huddleston, MD has indicated no relevant financial relationships to disclose.

Ann E. Kearns, MD, PhD has indicated no relevant financial relationships to disclose.

Jonathan M. Morris, MD has indicated no relevant financial relationships to disclose.

Staff Disclosure

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

The following PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, Jan Schultz, RN, MSN, CCMEP, and Patricia Staples, MSN, NP-C, CCRN hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

The following BroadWater, LLC planner(s) and manager(s), Julie Gentile, and Jeremy Longhurst, hereby state(s) that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interests related to the content of this CME activity.

Method of Participation

There are no fees for participating in and receiving CME credit for this activity. During the period December 22, 2011, through December 21, 2012, participants must:

  1. Read the learning objectives and faculty disclosures.
  2. Study the educational activity.
  3. Complete the post-test.
  4. Complete the evaluation form.
  5. Submit the completed post-test and evaluation form via SpineCME.org. Participants will be able to obtain their statement of credit upon online submission of the completed post-test and evaluation with a score of 70% or better.

For any questions relating to the accreditation of this activity please visit PIM's website: www.pimed.com.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Off-Label/Investigational Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. PIM, BroadWater, LLC, Lilly, Inc. and Medtronic, do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, BroadWater, LLC, Lilly, Inc. or Medtronic. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Software Requirements