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CME: Postmenopausal osteoporosis risk stratification and treatment of those at high risk for fracture

Activity Description / Statement of Need:

In this online CME self-learning activity:

Osteoporosis is a disease common among elderly patients and is increasing in frequency as senior citizens begin to represent a larger share of the US population. In the US, osteoporosis is associated with about 2 million broken bones each year, leading to over 500,000 hospitalizations, 800,000 emergency room visits, and 200,000 nursing home placements. By 2040, osteoporosis is expected to cause 3.2 million fractures per year in the United States at a cost of over $95 billion. Despite the morbidity and mortality associated with osteoporosis, practice gaps related to suboptimal screening, risk assessment, and management practices have led to underdiagnosis and undertreatment of this condition. Osteoporosis screening may identify people at increased risk of low-trauma fracture who may benefit from interventions to minimize risk. The US Preventive Services Task Force (USPSTF) recommends screening for osteoporosis with bone mineral density (BMD) testing in all women 65 years or older and in postmenopausal women younger than 65 years but at increased risk of osteoporosis. Risk for osteoporosis should be determined by a formal clinical measurement tool, such as FRAX™, which assesses 10-year fracture risk.

Target Audience:

HCPs specializing in endocrinology, internal medicine, and women’s health; physician assistants, nurse practitioners, and pharmacists who practice in those areas of specialty; and those who otherwise commonly care for or clinically encounter patients with postmenopausal osteoporosis.


Commercial Support Disclosure: This activity is supported by an educational grant from Radius Pharmaceuticals.

Learners may participate in this activity free of charge.


Release Date: July 03, 2020 -- Expiration Date: July 03, 2022

Faculty: Violet Lagari, DO, MPH

Agenda

 

Faculty introduction, disclosures

Introduction content: Cursory refresher and review of postmenopausal osteoporosis

Epidemiology

  • Differential diagnosis: Ruling out vitamin D deficiency and other endocrine and metabolic disorders
  • Patient cases

Risk assessment and diagnosis

  • Established and emerging risk factors for postmenopausal osteoporosis and for fracture
  • Bone mineral density, dual-energy X-ray absorptiometry, T-scores, and bone metabolic biomarkers
  • The role of the specialist in community engagement with osteoporosis screening in postmenopausal women

Treatment and prevention of osteoporosis

  • Clinical trial findings and guideline updates
  • A review of present pharmacotherapy; present controversies and risks to include:
    • Atrial fibrillation
    • Esophageal cancer
    • Atypical fractures
    • Osteonecrosis of the jaw
    • Acute renal failure
    • REMS guidelines
    • Dermatologic reactions
    • Infections
    • Osteosarcoma
    • Patient education burden
  • Therapies approved in recent years
    • Mechanisms of action
    • Role in management
    • Emerging evidence for use
    • Patient-specific treatment considerations
  • Emerging therapies
  • Optimizing adherence to therapy
  • Patient case(s)


Summary, conclusions, and best practice recap

 

Learning Objectives

By the end of the session the participant will be able to:

  • Recall how the results of diagnostic imaging and pertinent past medical history to determine risk of fracture.
  • List the criteria for initiation of pharmacotherapy for postmenopausal osteoporosis treatment and prevention and apply them to a patient case.
  • Describe challenges associated with treating patients with postmenopausal osteoporosis, focusing specifically on the risks of the agents used to treat and prevent osteoporosis, and apply the information to optimize patient care in a patient case.
  • Identify recently approved and emerging pharmacotherapeutic treatments for management of postmenopausal osteoporosis, and describe their mechanisms of action.

Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

PhysiciansFor maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: Not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in this section, then it does NOT provide MOC credit. This activity provides MOC credit only for ABIM.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 hours (0.1 CEUs) of continuing education.  Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-20-025-H01-P. CPE credit effective 7/3/20 and expires 7/3/22.

This is a Knowledge (K)-type activity.

Pharmacists: You must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure: Violet Lagari, DO, MPH, Associate Professor, University of Miami School of Medicine, Endocrinology Section Chief, Miami VAHS, has no relevent conflicts of interest to disclose.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.
 
Commercial Support Disclosure: This activity is supported by an educational grant from Radius Pharmaceuticals

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.