eLearning in less than 60 minutes

Changes/additions to materials:

Osteoporosis – Don’t forget falls prevention
Among the elderly, the greatest risk of fracture comes from falls, not osteoporosis. Bone mineral density measurement may be imprecise and it should not be used alone to estimate fracture risk or guide treatment decisions. All older people with recurrent falls or assessed as being at increased risk of falling should be considered for an individualised multifactorial intervention to reduce their risk. However, absolute reductions in the number of fallers may be smaller than previously thought. See blog for more details.

Healthcare professionals should follow the NICE guideline on the assessment and prevention of falls in older people. In addition, NICE has recently published two technology appraisals on the use of drugs for the primary and secondary prevention of osteoporotic fragility fractures in postmenopausal women with osteoporosis. NICE is developing a clinical guideline on ‘Osteoporosis: assessment of fracture risk and the prevention of osteoporotic fractures in individuals at high risk’. The development of this is currently being reviewed following the publication of the technology appraisals.

Calcium supplements may increase the risk of MI

A study has found that myocardial infarction (MI) stroke or sudden death occurred more commonly in women receiving calcium supplements than those taking placebo. However, calcium supplementation alone should not generally be prescribed to postmenopausal women for fracture prevention and it is unclear whether calcium plus vitamin D could carry the same risk of MI.

Clinicians should weigh up the pros and cons of calcium and vitamin D supplementation on an individual basis, taking into account the patient’s risk of CV disease and osteoporosis. See the related blog for further information regarding the study and its limitations.

In this room you will find a series of workshops using a multimedia presentation of PowerPoint slides with audio commentary by the NPC team. You will need speakers and a sound card in your computer.

The outline of each short presentation is given below. Simply click on one of the underlined links and then click on the play icon to begin. You can jump forwards to skip a slide or backwards to repeat a slide by clicking the relevant slide on the left hand side of the console.

Section 1 Introduction and background (14min 25secs)

• What is osteoporosis, what is the associated morbidity and mortality?
• Who should we treat and how do we measure treatment success?

Section 2 Non–drug and drug interventions (31min 37secs)

• Falls prevention/hip protectors
• Calcium and vitamin D
• Bisphosphonates, raloxifene, calcitonin, teriparatide▼, strontium▼

Section 3 Specialist groups with osteoporosis and summary (14min 29secs)

• Osteoporosis and corticosteroids
• Osteoporosis in men
• Overall summary of evidence for drug therapies
• Absolute benefits in different population