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Own the Bone launches a new Website
Visit Own the Bone’s brand new website at www.ownthebone.org. The website provides the latest news and events, program information, and educational resources, for subscribers as well as for institutions interested in starting an Own the Bone program.
For existing Own the Bone subscribers, the website has a number of new features, including subscriber’s only resources and a forum to share best practices, comments and questions. To access these features, subscribers will need a user ID and password provided by Own the Bone. If you have not recieved these, please contact Own the Bone at ownthebone@aoassn.org. Once you log in to the Own the Bone website, a “My AOA” page will appear. From there you will be able to click on various Own the Bone features, including the Subscribers Only Resources and the Own the Bone Subscriber’s Forum. To go back to the Own the Bone Home page once you are logged in, simply click on the “Own the Bone” header.
Headlines
Program Updates and Announcements:
Own the Bone Registry Training - August 11th
Visit the Own the Bone Team at the Chicago Trauma Symposium
Own the Bone Texas Regional Educational Symposium
Own the Bone Featured in Good Housekeeping
Welcome to new Own the Bone Institutions
New Webinar Recording Available: Own the Bone in Practice at OAM and Community Medical
Release of Aggregated Registry Data Through June 2011 - How does your site measure up?
Link to Bone Health News:
Older Women Who Take Vitamin D3 May Live Longer
Increasing Calcium Intake Does Not Reduce Further Fracture Risk
Along the Spine, Women Buckle at Breaking Points
Wrinkles May Signal Bone Risk: Study
Low Vitamin D Levels are Related to Decreased Response to Osteoporosis Medicine
Association of BMD and FRAX Score With Risk of Fracture in Older Adults With Type 2 Diabetes
Heart Failure, Weak Bones Often Go Together, Study Finds
High Thyroid Drug Dose Ups Seniors' Fracture Risk
The Vitamin D-lemma
FDA Panel to Discuss Safety of Osteoporosis Drugs
Final Shuttle Flight Will Let Amgen Test Drug in Space
Program Updates and Announcements:
Own the Bone Registry Training - August 11th
Own the Bone subscribers can join us on August 11th, 1:00pm - 2:00pm EDT for a live registry training hosted by Clinipace, the Own the Bone registry provider.
This session will provide existing Own the Bone sites an opportunity to learn how to begin entering patients into the Own the Bone web-based registry.
To register, please call (847) 318-7336 or e-mail ownthebone@aoassn.org.
Visit the Own the Bone Team at the Chicago Trauma Symposium
Own the Bone will exhibit at the 13th Annual Chicago Trauma Symposium from August 25 - 28th at the Palmer House Hilton in Chicago. Visit our booth to find out more about Own the Bone.
The program at the Chicago Trauma Symposium will include a session on “Fragility Fractures in the Elderly”. For additional information about attending the Chicago Trauma Symposium, please visit chicagotraumasymposium.com.
Own the Bone Texas Regional Educational Symposium
Join us on Wednesday, October 12, 2011 at the Marriott Riverwalk Hotel in San Antonio, TX for dinner and a panel presentation on Own the Bone. The Own the Bone Texas Regional Educational Symposium is being held as a pre-meeting course of the Orthopaedic Trauma Association’s 27th Annual Meeting. The symposium will focus on practice management aspects of establishing an osteoporotic fracture program. Panel members will discuss their experience with different medical practitioners, working together to introduce Own the Bone and other post-fracture, systems-based quality improvement initiatives within their institutions to address patients’ bone health and osteoporosis.
For more information or to register for the OTA meeting, visit Orthopaedic Trauma Association’s 27th Annual Meeting website. Non-OTA members can call 847-318-7336 or email ownthebone@aoassn.org to register for the Own the Bone Symposium.
Own the Bone Featured in Good Housekeeping
Own the Bone was featured in “Fractured: A Special Report on Osteoporosis” published in the July issue of Good Housekeeping. The article also included quotes from Steering Committee Members Andrew D. Bunta, MD and Beatrice Edwards, MD. For additional information and to read the full article, visit www.goodhousekeeping.com.
Welcome to new Own the Bone Institutions
The Own the Bone team welcomes the institutions below who enrolled in the Own the Bone program since April 2011 and congratulates those that are the first in their state to implement Own the Bone.
Ball Memorial Hospital, Muncie, IN
Borgess Medical Center/Borgess Bone & Joint Institute, Kalamazoo, MI
Carolinas Medical Center, Charlotte, NC
Central Peninsula Hospital, Soldotna, AK - First in State of Alaska
Crystal Clinic Orthopaedic Center, Akron, OH
Ellis Medicine, Schenectady, NY
Forsyth Medical Center, Winston-Salem, NC
Holland Hospital Bone Health Services, Zeeland, MI
Michigan State University Kalamazoo Center for Medical Studies, Kalamazoo, MI
Ocean Springs Hospital, Ocean Springs, MS – First in State of Mississippi
Penn Presbyterian Medical Center, Philadelphia, PA
St. Luke’s Orthopaedic Specialists – Bethlehem, PA
Sanford Medical Center Fargo, Fargo, ND – First in State of North Dakota
Somerset Central Medical Associates, Somerset, PA
United Memorial Medical Center, Batavia, NY
New Webinar Recording Available: Own the Bone in Practice at OAM and Community Medical
On June 17th, Debra Sietsema, RN, PhD (Orthopaedic Associates of Michigan) and Linda Hightower, RN, ONC (Community Medical Center) provided an overview of the Own the Bone program, described how their programs works, including information on Joint Commission disease specific care certification, and answered questions from participants.
Visit https://cc.readytalk.com/play?id=c1vjiq to view and listen to the recording.
Release of Aggregated Registry Data Through June 2011 - How does your site measure up?
Principal Investigators at enrolled Own the Bone sites will soon receive a series of graphs comparing their institution’s performance through the first half of 2011 against the aggregated data of all participating sites nationwide. This will show how you are improving patient care compared to other institutions enrolled in Own the Bone. Following our mailing, we will hold an “ask the expert” teleconference in the fall to discuss the Own the Bone data, what it means for your institution, and how you can match the performance of top Own the Bone performers.
If you are subscribed to Own the Bone and would like to participate in the “ask the expert” teleconference, please contact Own the Bone.
Bone Health News:
Older Women Who Take Vitamin D3 May Live Longer
Vitamin D3 may reduce elderly women’s risk of death, according to recent research. An analysis of 50 clinical trials involving over 94,000 older adults, primarily women residing in nursing homes, showed that those given vitamin D3 had a six percent lower risk of dying over the two-year study period than those given a placebo, other forms of vitamin D, or nothing. While the studies did not determine why participants taking vitamin D3 had lower mortality rates, or what the optimal dose of vitamin D3 might be for this group, the researchers speculate that the supplements may help reduce the risk of fractures, which can lead to fatal complications in elderly patients. Vitamin D3 (cholecalciferol) is more potent and easily absorbed than the more commonly found vitamin D2 (ergocalciferol), but few trials have tested whether vitamin D2 or other forms of the vitamin would also lower mortality in elderly women. In the trials, 800 IU of vitamin D3 was associated with a reduced risk of death, which is the current Institute of Medicine (IOM), recommended daily amount for older adults who have less exposure to the sun and are less able to absorb and use vitamin D. The researchers advise discussing supplementation with a physician and not exceeding the recommended daily intake, which can lead to vitamin D toxicity, causing nausea, vomiting, constipation, poor appetite, kidney stones, and heart disturbances. Food sources of vitamin D are fatty fish and fortified dairy and cereal products.
From "Older Women Who Take Vitamin D3 May Live Longer"
Reuters (07/07/11) Norton, Amy
Increasing Calcium Intake Does Not Reduce Further Fracture Risk
Consuming more than 700 mg of calcium per day in later years does not reduce the risk for fracture or osteoporosis further, according to the findings of a large study from Sweden. In fact, doing so may increase the risk for hip fracture. The study involved more than 61,000 women between 63 and 97 years of age who took part in the Swedish Mammography Cohort, established in 1987. During 19 years of follow-up, almost 15,000 women, or just about one-quarter, experienced some type of first fracture. Among those, 6 percent experienced a first hip fracture. Among roughly 5,000 women who participated in a subcohort, 20 percent met the criteria for osteoporosis. The researchers found that the risk patterns associated with dietary calcium intake were nonlinear. They found that the rate of a first fracture of any type among women in the first quintile of calcium intake was 17.2 per 1,000 person-years at risk, while those in the lowest quintile were at highest risk for a first hip fracture; a low vitamin D intake made the rate of fracture in the first calcium quintile even more pronounced.
From "Increasing Calcium Intake Does Not Reduce Further Fracture Risk"
Modern Medicine (07/01/11) Warensjo, E.; Byberg, L.; Melhus, H.; et al.
Along the Spine, Women Buckle at Breaking Points
Forty percent of women have at least one vertebral fracture by the time they are 80 due to bone loss. Often undiagnosed, these fractures lead to chronic back pain, impaired movement, and lower quality of life. When properly diagnosed, appropriate treatment for bone loss can prevent future fractures of vulnerable vertebrae, hips, and wrists. Fractures are often first detected when patients are given X-rays for other medical issues, but not necessarily treated. Sneezing, coughing, and turning over in bed may cause vertebral fractures in someone with severe osteoporosis; tripping, falling, and lifting heavy objects may cause fractures in less severe cases. Bone mineral density test scores may not be accurate since nearly one-third of postmenopausal women diagnosed with osteopenia, a less severe form of bone loss, have vertebral fractures, an indication of osteoporosis, and should be receiving bone-preserving medication. A more accurate test is a scan of the spine called a lateral DEXA. Medications such as bisphosphonate like Fosamax, available in an inexpensive generic form, can help increase bone strength, along with consuming 1,200 milligrams of calcium and 1,000 IUs of vitamin D each day through food and supplements. Treat vertebral fractures with nonsteroidal anti-inflammatory medications and short periods of bed rest. Vertebroplasty and kyphoplasty procedures that inject a cement-like substance into the compressed vertebra to stabilize it, have not been found effective and carry significant risks. Exercises to improve posture, strength, mobility, and balance are considered more effective. Avoid exercises that stress the spine with twisting and bending motions. When lifting heavy objects, avoid twisting motions and bend the knees and hips not the waist.
From "Along the Spine, Women Buckle at Breaking Points"
Seattle Times (06/28/11) Brody, Jane E.
Wrinkles May Signal Bone Risk: Study
Women who develop deep wrinkles in early menopause may be at higher risk for osteoporosis, according to a new Yale University study. Researchers studied 114 women who were post-menopausal for three years or less and found that those with deep wrinkles on their face and neck had lower bone density than those with more rigid skin. The body’s production of collagen, a protein that is the building block of both skin and bones, decreases with age. Aging skin, due to loss of collagen is an outward sign of changes affecting bone health, and may help doctors identify women at risk for fractures without the use of costly tests. The study results were adjusted for age, body mass index, tobacco use, ethnicity, race, and multivitamin use. The researchers plan to follow up with study participants to determine whether women with less rigid skin lose bone mass more quickly than those with more rigid skin over time.
From "Wrinkles May Signal Bone Risk: Study"
Chicago Tribune (06/10/11) Deardorff, Julie
Low Vitamin D Levels are Related to Decreased Response to Osteoporosis Medicine
Bisphosphonate drugs are seven times more beneficial to women with low bone density and higher blood levels of vitamin D, according to a recent study. The Institute of Medicine recently gave baseline recommendations for vitamin D intake of 600 IU each day, along with adequate amounts of calcium to maintain minimum adequate 25-hydroxyvitamin D blood levels of 20 ng/mL, but the study shows that this level may be too low. Of the 160 postmenopausal women with osteoporosis in the study, nearly 78 percent with an average 25-hydroxyvitamin D blood level of 20 to 30 ng/mL did not respond to bisphosphonate treatment over 18 months, compared to 42.3 percent nonresponders with 25-hydroxyvitamin D level of 30 to 40 ng/mL, and only 24.6 percent nonresponders with 25-hydroxyvitamin D blood levels above 40 ng/mL. "This value of at least 33 ng/mL is higher than the level considered as "adequate" by the Institute of Medicine report for the general population and most likely requires a vitamin D intake higher than 600 IU for this therapeutic outcome," says study author Richard Bockman. "In the future, I think we're going to see vitamin D recommendations based on specific conditions." Study participants were considered nonresponders if they suffered a new fracture while receiving a bisphosphonate, if their bone density worsened by more than 3 percent on DEXA bone density scans obtained 18 to 60 months apart, or if they had persistently low DEXA T-score worse than -3. The research was presented at The Endocrine Society's 93rd Annual Meeting.
From "Low Vitamin D Levels are Related to Decreased Response to Osteoporosis Medicine"
EurekAlert (06/06/11)
Association of BMD and FRAX Score With Risk of Fracture in Older Adults With Type 2 Diabetes
Though type 2 diabetes is associated with a higher bone mineral density (BMD), it is also associated with a higher risk of fracture. A recent study sought to determine if the bone mineral density T score and the World Health Organization Fracture Risk Algorithm (FRAX) score are associated with an elevated risk of hip and nonspine fracture in older adults with type 2 diabetes. Data from three observational studies of 9,449 older adult women and 7,436 older adult men were analyzed. Through their analysis the researchers concluded that older adults with type 2 diabetes, femoral neck BMD T score and FRAX score were associated with hip and nonspine fracture risk; however, in these patients the fracture risk was higher for a given T score and age or for a given FRAX score than those without type 2 diabetes.
From "Association of BMD and FRAX Score With Risk of Fracture in Older Adults With Type 2 Diabetes"
Journal of the American Medical Association (06/01/11) Vol. 305, No. 21, P. 2184 Schwartz Ann V.; Vittinghoff, Eric; Bauer, Douglas C.; et al.
Heart Failure, Weak Bones Often Go Together, Study Finds
A recent study reveals that osteoporosis often goes undiagnosed and untreated in elderly heart failure patients. Researchers in Canada focused on 623 heart failure patients with an average age of 69 and found that 12 percent of them had moderate to severe compression fractures in the spine. In addition, 55 percent of these patients had multiple spinal fractures, which are a sign of osteoporosis. Just 15 percent of the heart failure patients with spinal fractures were being treated for osteoporosis, the investigators found. The researchers concluded that heart failure patients who also had atrial fibrillation were twice as likely to have spinal fractures as those with normal heart rhythms. Study senior author Dr. Justin E. Ezekowitz recommended that when physicians review chest X-rays to look at the heart and lungs, they should also carefully examine the bones. "If fractures are found, patients need to be treated with dietary modification, exercise and, if indicated, osteoporosis medications. Treatment can reduce future fractures by as much as 50 percent," he said. The study authors also said it may be possible that high levels of the hormone aldosterone might explain the link between chronic heart failure, osteoporosis, and atrial fibrillation, although further tests are needed to verify the theory. The study is published May 10 in the journal Circulation: Heart Failure
From "Heart Failure, Weak Bones Often Go Together, Study Finds"
MedicineNet.com (05/10/11) Preidt, Robert
High Thyroid Drug Dose Ups Seniors' Fracture Risk
Older adults with underactive thyroid who are prescribed the drug levothyroxine may be at a higher risk for hip and other fractures, according to a study by Toronto researchers. The study found that older people on medium to high doses of the medication were 2.5 to three times more likely to suffer a fracture than those on a low dose. Report co-author Paula Rochon with Women's College Hospital says the finding is particularly relevant to women because hypothyroidism is common among women. Although regular monitoring of patients on levothyroxine is advised, doses frequently remain unchanged into old age, which can lead to excess thyroid hormone levels and a greater risk of fractures. "This is a therapy that people may have started when they were quite young and they need to stay on for very long periods of time, indefinitely," Rochon notes. "So I think this work highlights the need to continue to carefully monitor the dose of the thyroid medication that's being given and to decide if there's a need for any kind of dose adjustment." Rochon says it has long been established that long-term use of the medication can induce a thinning of bone density, while older people also are already more susceptible to falls. The Toronto researchers suggest in their report that the higher fracture risk is dose-related in older adults, and that dosages regularly prescribed by physicians may be excessive for this population.
From "High Thyroid Drug Dose Ups Seniors' Fracture Risk"
Canadian Press (04/29/11) Ubelacker, Sheryl
The Vitamin D-lemma
Fierce debate has erupted over a report from a panel organized by the Institute of Medicine (IOM) suggesting that blood levels of vitamin D need not be as high as many doctors and testing companies have long recommended, and that high doses could actually cause damage. Several vitamin D advocates say that the institute's techniques, which entailed a systematic review of the literature, were flawed, and they have charged the panel with misinterpreting data and overemphasizing the hazards of heavy supplementation. Some doctors recommend vitamin D supplementation of up to 6,000 international units (IU) daily, but the panel concluded that people should aim for blood levels of 50 nanomoles per liter, which can be accomplished with 600 IU of vitamin D per day, which does not necessarily require supplementation. "Basically, the vitamin D recommendations are based on low-quality evidence," argues Gordon Guyatt, a clinician researcher at Ontario's McMaster University. Michael Amling at Germany's University Medical Center Hamburg-Eppendorf says IOM made a mathematical error, in that it should have examined the risk of weak bones in people at or above a certain level rather than in the entire population. Clifford Rosen with the Maine Medical Center Research Institute counters that the technique the IOM employed to calculate 1 percent risk is standard protocol for dietary recommendations. The panel's members concede that the case for vitamin D benefiting general health is not concluded, and say that the best way to clarify it is with major clinical trials.
From "The Vitamin D-lemma"
Nature (07/07/11) Vol. 475, No. 7354, P. 23 Maxmen, Amy
FDA Panel to Discuss Safety of Osteoporosis Drugs
A Food and Drug Administration advisory panel will meet Sept. 9 to discuss the long-term safety of drugs used to treat osteoporosis. The panel will discuss bisphosphonates, which have been associated with a rare type of thigh fracture and osteonecrosis of the jaw, or jawbone death, when they are used over a long period. The FDA last year strengthened warning labels on the drugs and said doctors should periodically evaluate the need for continued bisphosphonate therapy for patients who have been on the drugs for longer than five years.
From "FDA Panel to Discuss Safety of Osteoporosis Drugs"
Dow Jones Newswires (07/08/11) Dooren, Jennifer Corbett
Final Shuttle Flight Will Let Amgen Test Drug in Space
Thirty mice were on board the final mission of the space shuttle Atlantis, to help determine if a new drug can prevent bone loss associated with space flight. The drug is a bone-building sclerostin antibody being developed by Amgen in collaboration with UCB. Because zero gravity in space flight causes bone loss, the space shuttle flight offers an important opportunity to study how the new drug could be used in patients losing bone mass due to immobilization or disuse conditions such as stroke, cerebral palsy, muscular dystrophy, and spinal cord injury. Scientists will compare the bone mineral density of the 15 mice aboard the shuttle that received the sclerostin antibody with the 15 mice on board that received a placebo, and with 30 Earth-bound mice that also received either the drug or the placebo.
From "Final Shuttle Flight Will Let Amgen Test Drug in Space"
Ventura County Star (CA) (07/08/11) Bruce, Allison
Abstract News © Copyright 2011 INFORMATION, INC.
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