Osteoporosis is a major public health concern, particularly for aging women. It has been estimated that in 2010, there were 158 million individuals worldwide age 50 years and older (87% of whom were women) at high risk of osteoporotic fracture, with that number expected to double by 2014. The burden of osteoporotic fractures is high. Fractures of the hip and spine are associated with an increase in mortality of about 20%; of those who survive, many will be impaired and have some form of disability.
Despite the availability of treatments proven to reduce fracture risk and accumulating evidence that osteoporosis treatment can prolong life, osteoporosis remains underdiagnosed and undertreated, with only about 20% of patients with hip fracture treated to reduce the risk of future fracture.
The Bone Health TeleECHO Clinic consists of 50 weekly 1-hour sessions, each having 50 minutes of interactive case-based learning and 10 minutes of didactic presentation, with 40 of the didactic topics set in advance and 10 open topics to be determined according to requests of participants, new developments in knowledge of osteoporosis, emerging topics of interest, controversies, and recently published journal articles. The Bone Health ECHO team consists of E. Michael Lewiecki, MD, FACP, FACE and other specialists having expertise in different aspects in the care of osteoporosis, gout, osteoarthritis and other bone conditions (e.g., physical therapy, nutrition, pharmacy, and psychology).Objectives: Participants of this new ECHO should be able to
- Describe the pathophysiology of common bone disorders
- Assess fracture risk with available validated clinical tools
- Evaluate for factors contributing to skeletal fragility
- Recognize quality in bone density testing acquisition, analysis, and reporting
- Use current clinical practice guidelines in managing patients with bone disorders
- Communicate the balance of benefits and risks with various treatments
- Individualize treatment decisions through shared decision making
- Monitor bone health therapy for adherence, tolerance, and effectiveness
- Implement systematic strategies for secondary fracture prevention (fracture liaison services)
- Bone Health Case Presentation Template
- Statement of Collaboration on Bone Health ECHO
- Bone Health TeleECHO Clinic Curriculum 2016-2017
- Osteoporosis Foundation of New Mexico: Good source of information about the Santa Fe Bone Symposium, New Mexico Bone Club, Osteoporosis Support Group, Bone Health ECHO, and other OFNM osteoporosis educational activities for patients and healthcare professionals
- National Osteoporosis Foundation: The NOF is an excellent source of information for patients with osteoporosis. The NOF Clinician’s Guide to Prevention and Treatment of Osteoporosis can be downloaded here: https://my.nof.org/bone-soruce/education/clinicians-guide-to-the-prevention-and-treatment-of-osteoporosis.
- FRAX: FRAX is the WHO fracture risk assessment tool that is used with the NOF guidelines to identify patients who have a T-score between -1.0 and -2.5 whose fracture risk is high enough that pharmacological therapy to reduce fracture risk is indicated.
- American Bone Health: Visit here for patient education materials in English, Spanish, and other languages.
- International Osteoporosis Foundation: The IOF offers a superb website with a global perspective on osteoporosis with links to all major international osteoporosis societies.
- Fracture Liaison Service – Fracture Prevention Central: This is an initiative of the US National Bone Health Alliance providing education, strategies, and software to initiate and maintain FLS for secondary fracture prevention.
- Fracture Liaison Service – Capture the Fracture: The IOF has developed international programs for developing FLS and provides a great deal of helpful information here.
- Fracture Liaison Service – Own the Bone: The American Orthopaedic Association has a well-established FLS that is presented here.
- Calcium Calculator: The University of Alabama at Birmingham has allowed Project ECHO to use their 6 step Calcium Calculator.
E. Michael Lewiecki, MDMedical Director, Bone Health ECHO
UNM School of Medicine
Matt Bouchonville, MDMedical Director of Endo ECHO
UNM School of Medicine
Stephen Murillo, BSProgram Specialist
David Chafey, MDUNM Orthopedics
UNM School of Medicine
Rachelle Rochelle, MPAClinic Operations Manager
Tom P. Olenginski, MD, FACPRheumatology