Impact of Pharmacist-Led Community Bone Mineral Density Screenings

2005 ◽  
Vol 39 (2) ◽  
pp. 243-248 ◽  
Author(s):  
Kelly M Summers ◽  
Tina Penick Brock
Keyword(s):  
Bone Mineral Density ◽  
At Risk ◽  
Bone Mineral ◽  
Care Service ◽  
Treatment Recommendation ◽  
Caffeine Intake ◽  
Mineral Density ◽  
T Score ◽  
Patients At Risk ◽  
The Impact

BACKGROUND: Osteoporosis-associated fractures burden both individuals and the overall healthcare system. Bone mineral density (BMD) screening remains the gold standard measure for identifying patients at risk. OBJECTIVE: To determine the impact of convenient, pharmacist-led BMD screening and counseling sessions on identification and education of patients at risk for or with osteoporosis. METHODS: Nonpregnant persons >18 years of age were eligible for enrollment in this descriptive study. At an urban retail pharmacy, participants underwent risk factor assessment, peripheral BMD scanning, and personalized counseling. At 3 and 6 months after screening, subjects were questioned by telephone regarding any subsequent primary care provider (PCP) interactions, as well as any behaviors initiated and/or medications modified. RESULTS: Of the 102 subjects screened, 22.6% and 11.7% were identified as being at medium risk (T score −1.0 to −2.5) and high risk (T score −2.5 or less) for osteoporosis, respectively. By 6 months, 42.5% of the participants reported increasing their dietary intake of calcium, 29.3% began or increased calcium supplements, and 54.9% positively modified smoking status, exercise level, alcohol consumption, or caffeine intake. Additionally, 24 of 52 subjects who had discussed their results with a PCP by 6 months also received a treatment recommendation. Eighty-nine participants reported the community location increased their likelihood of receiving a BMD scan. CONCLUSIONS: Overall, pharmacist-led BMD screenings that include individualized counseling sessions appear convenient, accessible, and beneficial for patients. With the establishment of clinical benefit of and positive reception to such screenings, pharmacists can now look toward securing consistent reimbursement for this vital pharmaceutical care service.

In Vitro and in Vivo Spiral CT to Determine Bone Mineral Density: Initial Experience in Patients at Risk for Osteoporosis

Radiology ◽  
2004 ◽  
Vol 231 (3) ◽  
pp. 805-811 ◽  
Author(s):  
Thomas M. Link ◽  
Boris B. Koppers ◽  
Thomas Licht ◽  
Jan Bauer ◽  
Ying Lu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
At Risk ◽  
Bone Mineral ◽  
Spiral Ct ◽  
Initial Experience ◽  
Mineral Density ◽  
Patients At Risk

scholarly journals Enzyme-inducing antiseizure drugs associate with low bone mineral density in men with epilepsy

2021 ◽  
Author(s):  
Aline de Fátima Dias ◽  
Lucas Scárdua Silva ◽  
Rafael Batista João ◽  
Amanda Canal Rigotti ◽  
Gabriel Ferri Baltazar ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Age Of Onset ◽  
Young Group ◽  
Categorical Variables ◽  
Mineral Density ◽  
Chi Square ◽  
T Score ◽  
Age Range ◽  
The Impact

Introduction: Little is known about the impact of enzyme-inducing antiseizure drugs (EI-ASD) on the reduction of Bone Mineral Density (BMD) in men with epilepsy (MWE). Objectives: To evaluate the BMD in MWE exposed to EI-ASDs (phenytoin, carbamazepine and phenobarbital) and its relationship with the duration of epilepsy. Methods: We evaluated BMD from 74 consecutive MWE (median age (range), 52.5 (25- 74) years) exposed to previous or current EI-ASDs, followed at UNICAMP-Brazil. Individuals were split into two groups (young-group, 31 individuals [25-49 years]; older group, 43 subjects, [50-74 years]). The BMD test evaluated t-score indexes from the femoral neck, whole femur and lumbar spine. Osteopenia was defined with t-score of - 1.0 to -2.4; osteoporosis, with T-scores lower than -2.5. Data were extracted from medical records. We analyzed data with SPSS22, performed chi-square tests for categorical variables and applied a partial correlation test (controlled for age) between BD scores and duration of epilepsy. Results: BMD was reduced in 49/74 men (66.2%). Both groups presented equivalent proportions of BMD abnormalities (p=0.087) (young-group [14/41 normal (45%), 12/31 osteopenia (39%), 5/31 osteoporosis (16%)]; older-group [11/43 normal (26%), 16/43 osteopenia (37%), 16/43 osteoporosis (37%)]. BMD did not correlate with the duration of disease or age of onset. Conclusion: BMD reduction is highly prevalent in MWE exposed to EI-ASD, including young individuals. Data suggest that exposure to EI-ASD may associate with early BMD reduction, which evolve to osteopenia and osteoporosis. BMD evaluation in MWE and appropriate treatment may be necessary to reduce fractures’ risk.

Access to bone mineral density testing in patients at risk for osteoporosis

2006 ◽  
Vol 17 (12) ◽  
pp. 1749-1754 ◽  
Author(s):  
D. H. Solomon ◽  
J. M. Polinski ◽  
C. Truppo ◽  
C. Egan ◽  
S. Jan ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
At Risk ◽  
Bone Mineral ◽  
Mineral Density ◽  
Bone Mineral Density Testing ◽  
Patients At Risk

scholarly journals Influence of a diet and physical activity on the nutritional status of soldiers of the Polish Air Cavalry units

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Jerzy Bertrandt ◽  
Anna Anyzewska ◽  
Roman Lakomy ◽  
Tomasz Lepionka ◽  
Ewa Szarska ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Nutritional Status ◽  
Bone Mineral ◽  
Negative Correlation ◽  
Dominant Hand ◽  
Mineral Density ◽  
T Score ◽  
Diet And Physical Activity ◽  
The Impact

AbstractIntroductionResearch from recent years indicate a problem of excessive body weight among soldiers, who due to the kind of carried out work should reveal the best health and fitness. Moreover, proper nutritional status in case of soldiers is extremely important, as it significantly affects their physical fitness. The aim of the study was to determine impact of the diet and physical activity on selected indicators of protein-energy and mineral nutritional status.Materials and methodsOne hundred and twenty male soldiers (aged: 28 ± 5; years of service: 5 ± 5), serving completed validated for Polish population the Food Frequency Questionnaire and long-form International Physical Activity Questionnaire. Body composition was determined by an electric bioimpedance method (TANITA MC-780) and bone mineral density of forearm bone of the non-dominant hand was assessed by the DEXA densitometric method, using apparatus EXA 3000.Results and discussionThis study confirmed the impact of both the diet and physical activity on selected measures of soldiers’ nutritional status, i.e. fat mass index and bone mineral density. Out of selected 61 products negative correlation between FMI and frequency of apples and pears consumption (r = -0.23, p = 0,023), and positive correlation with frequency of beer (r = 0.20, p = 0.049) and vodka and spirits drinking (r = 0.26, p = 0.010) consumption were found. While the T-score value positively correlated with frequency of tropical fruits (r = 0.23, p = 0.024), avocado (r = 0.25, p = 0.014), fine-grained not refined groats (r = 0.22, p = 0.030) and eggs (r = 0.29, p = 0.004) consumption. A negative correlation was found for frequency of refined bread (r = -0.24, p = 0.019), sausages(r = -0.35, p < 0.023), high-quality cold cuts (r = -0.25, p = 0.014, sugar to sweeten beverages (r = -0.31, p = 0.002), biscuits and cakes (r = -0.23, p = 0.016), salty snacks (r = -0.23, p = 0.023), fruit juices and nectars (r = -0.28, p = 0.005) and sugar-sweetened beverages (r = -0.34, p = 0.001). A negative correlation with FMI (r = -0.22, p = 0.036) for weekly physical activity expressed in MET-minutes/week was found. Positive correlations were found between T-score value and physical activity expressed in MET-minutes per week in total, housework, house maintenance and caring for family (r = 0.22; p = 0.040), and recreation, sport and physical activity in leisure time (r = 0.25, p = 0.019), as well as moderate physical activity (r = 0.28, p = 0.008) and intense one (r = 0.21, p = 0.046). The founded abnormalities in nutritional status, as well as numerous nutritional errors indicate a need for further monitoring of this group of soldiers, not only in terms of accuracy of nutritional status, their diet and physical activity, but also wider understood health behavior

scholarly journals OP0324 CLUSTERING OF FRAGILITY FRACTURES BY SITE IN PATIENTS REFERRED FOR BONE MINERAL DENSITY ESTIMATION: AN OBSERVATIONAL STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 199.2-199
Author(s):  
M. Dey ◽  
M. Bukhari
Keyword(s):  
Bone Mineral Density ◽  
At Risk ◽  
Cluster Analysis ◽  
Bone Mineral ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Jaccard Similarity ◽  
T Score ◽  
Risk Patients ◽  
Clinical Records

Background:Fragility fractures (FF) are those resulting from mechanical forces equivalent to a fall from standing height or less [1]. They most commonly occur in the spine (vertebrae), forearm, and femur, but also occur at other sites. Prevalence markedly increases with age, due to age-related and menopause-related bone loss. FF cause substantial pain and disability, and are associated with decreased life expectancy. While many studies have investigated risk factors associated with FF, there are few data on the association between FF sites in at-risk patients.Objectives:1. Establish the most common sites of FF in patients presenting for bone mineral density (BMD) estimation.2. Identify patterns of co-existing FF in the above cohort by applying cluster analysis.Methods:We retrospectively reviewed the clinical records of 28868 patients presenting for BMD estimation at a district general hospital in North West England, 2004-2016, identifying those who had sustained one or more FF. Site(s) of FF were recorded for each patient, categorised as: ankle, elbow, femur, forearm, humerus, pelvis, ribs, spine, tibia or fibula (recorded as “tibfib”). Cluster analysis was performed on fracture sites, using Jaccard similarity coefficient. Results were plotted on a dendrogram and divided into clusters, as per results derived from elbow and silhouette cluster methods.Results:Out of 28868 patients presenting for BMD estimation, 11003 were identified as having sustained one or more FF. 84.6% patients were female, with overall mean age 67.5years and median T-score -1.12 SD. The most common site of FF was the forearm (n=5045), most commonly co-existing with fractures of the tibia or fibula. Frequencies of the most common and co-existing FF sites are shown in Figure 1 (top). Cluster analysis identified 3 clusters: ankle and elbow; forearm, tibia/fibula, ribs, and spine; pelvis, femur, and humerus. The second half of Figure 1 displays the dendrogram of cluster analysis results, with Jaccard similarity measure.Conclusion:We applied cluster analysis to a large cohort of patients presenting for BMD estimation. Our results are in keeping with previous studies demonstrating the FF to most commonly occur in the forearm, and in those with osteopenia (T-score -2.5 < -1 SD) [2]. To our knowledge, this is the first study to apply cluster analysis to sites of FF. Results may be due to differences in cortical and trabecular bone structure, and have potential to aid prevention, monitoring, and management in at-risk patients.References:[1]National Institute for Health and Care Excellence (NICE). Osteoporosis: assessing the risk of fragility fracture - Clinical Guideline (CG146). 2012;(August):1–14.[2]Siris ES et al. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med. 2004 May 24;164(10):1108–12.Disclosure of Interests:Mrinalini Dey: None declared, Marwan Bukhari Speakers bureau: Bristol-Myers Squib, UCB celltech, Roche/Chugai, Pfizer, Abbvie, Merck, Mennarini, Sanofi-aventis, Eli-Lilly, Janssen, Amgen and Novartis.

scholarly journals Impact of hypogonadism on bone mineral density and vertebral fractures in HIV-infected men

2021 ◽  
Author(s):  
L. C. Pezzaioli ◽  
T. Porcelli ◽  
A. Delbarba ◽  
F. Maffezzoni ◽  
E. Focà ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Bone Health ◽  
Sex Hormone Binding Globulin ◽  
Gonadal Function ◽  
Mineral Density ◽  
T Score ◽  
Normal Bone Mineral Density ◽  
The Impact

Abstract Purpose Hypogonadism and osteoporosis are frequently reported in HIV-infected men and, besides multifactorial pathogenesis, they might be directly linked because of testicular involvement in bone health. We evaluated the prevalence of osteoporosis and vertebral fractures (VFs) in HIV-infected men, and assessed their relationship with gonadal function. Methods We enrolled 168 HIV-infected men (median age 53). Osteoporosis and osteopenia were defined with T-score ≤  – 2.5SD and T-score between  – 1 and  – 2.5SD, respectively. VFs were assessed by quantitative morphometric analysis. Total testosterone (TT), calculated free testosterone (cFT), Sex Hormone Binding Globulin (SHBG), Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) were obtained; overt hypogonadism was defined on symptoms and low TT or cFT, and classified into primary and secondary according to gonadotropins; compensated hypogonadism was defined as normal TT and cFT with high LH levels. Results Overall, osteoporosis and osteopenia were found in 87.5% of patients, and VFs were detected in 25% of them; hypogonadism was identified in 26.2% of cases. Osteoporotic patients had higher SHBG vs those with normal bone mineral density (BMD). Fractured patients were more frequently hypogonadal and with higher SHBG. SHBG showed negative correlation with both spine and femoral BMD, and positive correlation with VFs. In multivariate models, FSH showed negative impact only on femoral BMD, whereas older age and higher SHBG predicted VFs. Conclusion We found a high burden of bone disease and hypogonadism in HIV-infected men, and we showed that the impact of gonadal function on bone health is more evident on VFs than on BMD.

scholarly journals AB0908 ASSESSMENT OF THE IMPACT OF THE LEAN MASS WITH BODY COMPOSITION BY DUAL-ENERGY X-RAY ABSORPTIOMETRY ON THE BONE MINERAL DENSITY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1756.3-1756
Author(s):  
M. Nikolov ◽  
N. Nikolov
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Bone Mineral ◽  
Lean Mass ◽  
Dual Energy ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
The Impact

Background:Lean mass, mainly composed of muscle, has been correlated to bone mineral density (BMD) [4]. Studies reported that lean mass has an important impact on BMD not only in young women but also in postmenopausal women [1]. High lean mass is more favorable for the BMD than low lean mass. Some studies suggested that genetic factors responsible for both lean mass and BMD are shared [3]. Low muscle mass and low BMD could impair the quality of the patient’s life [2, 5].Objectives:The aim of this study is to assess the impact of the lean mass with body composition by dual-energy X-ray absorptiometry on the bone mineral density.Methods:107 women underwent body composition analysis by dual-energy X-ray absorptiometry (DXA). Lean mass in kg and BMD in kg/cm2 were analyzed. Normal BMD was defined as T-score > -1.0 standard deviation (SD). Osteopenia was defined as T-score between -1.0 SDs and -2.5 SDs and osteoporosis was defined as T-score ≤ - 2.5 SDs.Results:The mean age of the women was 57 years (yrs.) ± 11 yrs. (range 41 yrs. – 80 yrs.). Subjects had mean weight of 75 kg ± 12 kg (range 50 kg – 110 kg) and mean height of 156 cm ± 9 cm (range 151 cm – 172 cm). 73/107 women (68.2%) were with normal BMD, 24/107 women (22.4%) were with osteopenia and 10/107 women (9.4%) were with osteoporosis. Lean mass differed significantly between the groups (p = 0.000). Women with normal BMD had the highest mean lean mass (58.47 kg) and the mean lean mass of the women with osteopenia and osteoporosis decreased as follow: 47.56 kg for women with osteopenia and 36.22 kg for women with osteoporosis.Conclusion:Women with osteoporosis have the lowest lean mass compared to the women with osteopenia and osteoporosis.References:[1]Ilesanmi-Oyelere BL, Coad J, Roy N, Kruger MC. Lean Body Mass in the Prediction of Bone Mineral Density in Postmenopausal Women. Biores Open Access. 2018;7(1):150–158. Published 2018 Oct 10. doi:10.1089/biores.2018.0025.[2]Kirilov N., Vladeva SG, Kirilova E. Assessment on the Improvement of the Quality of Life after One Year of Regular Physical Activity and Treatment in Patients with Postmenopausal OsteoporosisCOR 2017: 19th International Conference on Orthopedics and Rheumatology Miami, USA March 9 - 10, 2017, WASET, Paper Code 17US030051.[3]Nguyen TV, Howard GM, Kelly PJ, Eisman JA. Bone mass, lean mass, and fat mass: same genes or same environments? Am J Epidemiol. 1998 Jan 1;147(1):3-16.[4]Patel HP, Dawson A, Westbury LD, et al. Muscle Mass, Muscle Morphology and Bone Health Among Community-Dwelling Older Men: Findings from the Hertfordshire Sarcopenia Study (HSS). Calcif Tissue Int. 2018;103(1):35–43. doi:10.1007/s00223-018-0388-2.[5]Kirilova E, Kirilov N, Vladeva S. A study on the physical activity in women with decreased bone mineral density. Abstract book 13thscience conference MC, PlevenDisclosure of Interests:None declared

scholarly journals Bone mineral density assessment by DXA in rheumatic patients with end-stage osteoarthritis undergoing total joint arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Moritz Mühlenfeld ◽  
André Strahl ◽  
Ulrich Bechler ◽  
Nico Maximilian Jandl ◽  
Jan Hubert ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Rheumatic Diseases ◽  
Total Joint Arthroplasty ◽  
Joint Destruction ◽  
Joint Arthroplasty ◽  
Mineral Density ◽  
T Score ◽  
End Stage ◽  
Rheumatic Patients

Abstract Background Patients with rheumatic diseases have a high risk for joint destruction and secondary osteoarthritis (OA) as well as low bone mineral density (BMD, i.e., osteoporosis). While several factors may lead to low BMD in these patients, the value of BMD measurements in rheumatic patients with end-stage OA scheduled for total joint arthroplasty is unknown. Methods In this retrospective cross-sectional study of 50 adults with secondary OA due to rheumatic diseases, we evaluated dual energy X-ray absorptiometry (DXA) measurements of both hips and the spine performed within 3 months prior to arthroplasty (n = 25 total hip arthroplasty, THA; n = 25 total knee arthroplasty, TKA). We analyzed various demographic and disease-specific characteristics and their effect on DXA results by using group comparisons and multivariate linear regression models. Results Although patients undergoing TKA were younger (63.2 ± 14.2 vs. 71.0 ± 10.8 yr., p = 0.035), osteoporosis was observed more frequently in patients scheduled for TKA than THA (32% vs. 12%). Osteopenia was detected in 13/25 patients (52%) in both the THA and TKA cohort. In the THA cohort, female sex, lower BMI and prednisolone use were associated with lower T-score in the hip. In TKA patients, higher OA grade determined by Kellgren-Lawrence score was associated with lower T-score in the hip of the affected side. Conclusions Osteoporosis is present in a considerable frequency of rheumatic patients with end-stage OA, and THA and TKA patients show distinct frequencies and risk factors of low BMD. Our findings point to a potential value of DXA regarding preoperative evaluation of bone status.

scholarly journals Evaluation of association of fragility fracture and bone mineral density in Nepalese population

2013 ◽  
Vol 2 (2) ◽  
pp. 130-134
Author(s):  
Md. Farid Amanullah ◽  
BP Shrestha ◽  
GP Khanal ◽  
NK Karna ◽  
S Ansari ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Bone Mineral ◽  
Fragility Fracture ◽  
High Energy ◽  
Medical Illness ◽  
Mineral Density ◽  
T Score ◽  
Study Results

Background: Fragility fractures are one of the major health problems. Many factors are associated with it some of which are modifiable and some are not. If we know the value of T-score at which fragility fracture occurs and associated factors responsible for fragility fracture than we will be able to control this burden to the society. The objective of this study is to determine association between fragility fracture and bone mineral density (BMD) using bone densitometry and to know the value of T-score at which fragility fracture occurs. Methods: Patients presenting to B.P. Koirala Institute of Health Sciences with fragility fracture of distal end of radius, fracture around hip and vertebral fractures were included in the study to know the value of T-score at which fragility fracture occurs and their associated risk factor. Patients less than 50 years of age, high energy trauma fracture and pathological fractures were excluded from the study. Results: We found that being multipara, smoking, alcohol consumption, post-hysterectomized patients and steroid intake had significant association with fragility fracture. There was no association with religion, geographic location, associated medical illness, age, sex, associated injury and site of injury. Conclusion: The patients with risk factor for fragility fracture like smoking, alcohol consumption, multipara women, post-hysterectomized women and those who are on long term steroid therapy should undergo BMD test and the value at -3.254 are prone to fragility fracture and should be treated accordingly. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 130-134 DOI: http://dx.doi.org/10.3126/njms.v2i2.8956

scholarly journals A REVIEW: MECHANISTIC INSIGHTS INTO THE EFFECT OF THYROID DISORDERS ON ESTROGEN LEVEL AND BONE MINERAL DENSITY

2019 ◽  
pp. 9-17
Author(s):  
MINAKSHI JOSHI ◽  
SHRADHA BISHT ◽  
MAMTA F. SINGH
Keyword(s):  
Bone Mineral Density ◽  
Thyroid Hormone ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Disorders ◽  
Hypothyroid Patient ◽  
Mineral Density ◽  
Estrogen Level ◽  
The Impact

Thyroid hormone serves as an indispensable component for the optimum functioning of various biological systems. They curb body’s metabolism, regulates the estrogen level, regulates bone turnover, essential for skeletal development and mineralization. Within the scope of knowledge, it is intimately familiar that thyroid disorders have widespread systemic manifestations, among which in hypothyroidism, even though elevated TSH (thyroid-stimulating hormone) may reduce estrogen level which in turn stimulates osteoclasts and thus cause osteoporosis, while hyperthyroidism accelerates bone turnover. Hypothyroidism does not directly interfere with the skeletal integrity, but treatment with levothyroxine for the suppression of TSH to bring the hypothyroid patient to euthyroid state for a long haul; lead to simultaneous reduction in bone mass and in (bone mineral density) BMD. After the initial relevation of the correlation between thyroid disorders and osteoporosis in numerous studies have emphasized that both hypo and hyperthyroidism either directly or indirectly affects the bone mineral density or leads to the progression of osteoporosis. Therefore the present study is aimed and so designed to review all the possible associations between them and the impact of thyroid disorders on estrogen level and bone mineral density. The main findings of this review indicate that both excesses as well as deficiency of thyroid hormone can be potentially deleterious for bone tissue.

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