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Osteoporosis and Care Management

Posted by Dr. Joseph F. West on Jan 17, 2017 11:45:00 AM
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Osteoporosis is a disease that thins and weakens the bones to where they become fragile and easily broken. Osteoporosis is often called a "silent" disease because bone loss occurs without symptoms. Bones slowly and subtly lose density, becoming weaker over time. More than 50 million Americans either already have osteoporosis or are at high risk due to low bone mass. Although osteoporosis may be diagnosed at any age, it is mostly a disease of aging and predominantly affects older women. Osteoporosis generally isn’t discovered until there is a sudden fall or strain that leads to a broken bone or stress fracture.

Many things can affect the risk of falling, such as a patient’s balance, weakened eyesight, uneven flooring, stairs, furniture arrangement, and home accessibility. A broken bone resulting from a fall can limit mobility and have a major impact on a patient’s quality of life. Patients may feel an emotional as well as physical weight following a diagnosis of osteoporosis. Thus, they may experience bouts of depression, anxiety, or weariness caused by effects of the disease. Those most affected by the disease may be afraid to leave their homes or participate in previously enjoyed daily activities fearing injury.

Possible risk factors that can contribute to osteoporosis include:

  • early onset of menopause
  • family history
  • vitamin D or calcium deficiency
  • smoking or excessive drinking
  • rheumatoid arthritis
  • low estrogen levels in women
  • kidney or liver disease
  • some medications (e.g. some steroids)
  • other dietary or lifestyle issues
Chronic Care Managers (CCM) and Transitional Care Managers (TCM) can help patients and their caregivers be more mindful of the risks and consequences of osteoporosis. They can measure risk through assessment of diet, mobility, home care needs and lifestyle habits. CCM and TCM Care Managers can include monthly reminders for patients to continue to walk or remain engaged in light aerobics which helps maintain bone strength. Strength training with light weights or resistance bands can help increase muscle strength to better support bones.

Using electronic health records Care Managers can better document history and risks for falling, history of fractures, and bone fragility. Care Managers can work with patients and their caregivers to improve dietary habits that boost vitamin D and calcium intake, and encourage to quit smoking and their intake of alcoholic beverages. The Care Managers can also monitor for Nonsteroidal Anti-inflammatory Drugs (NSAIDs), opioid and substance abuse which can not only help with pain but also be a potential cause of the disease. Healthcare providers should assess older adults at high risk for osteoporosis during annual exams and at follow-up appointments for the disease. Recognizing symptoms and risk factors early will lead to preventative measures as well as prescribing appropriate medication and coordinating the right treatments to improve a patient's quality of life.

For more information on Chronic Care Management and Transitional Care Management solutions, visit NavCareNet.com.

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Topics: TCM, Falls, CCM, osteoporosis, Bone density


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