Portuguese recommendations for ordering bone densitometry measurement and indications for treatment to prevent osteoporotic fractures

Authors

  • Andréa Marques Serviço de Reumatologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Ana M. Rodrigues Em representação da Sociedade Portuguesa de Reumatologia (SPR)
  • José Carlos Romeu Serviço de Reumatologia, Hospital de Santa Maria, Lisboa, Portugal.
  • Afonso Ruano Em representação da Sociedade Portuguesa de Ortopedia e de Traumatologia (SPOT).
  • Ana Paula Barbosa Em representação da Sociedade Portuguesa de Osteoporose e Doenças Ósseas Metabólicas (SPODOM).
  • Eugénia Simões Em representação da Sociedade Portuguesa de Osteoporose e Doenças Ósseas Metabólicas (SPODOM).
  • Fernanda Águas Em representação da Sociedade Portuguesa de Ginecologia (SPG).
  • Helena Canhão Unidade de Investigação em Reumatologia, Instituto Medicina Molecular, Universidade de Lisboa, Hospital de Santa Maria, Lisboa, Portugal.
  • José Delgado Alves Serviço Medicina 4, Hospital Prof. Doutor Fernando Fonseca. CEDOC/NOVA Escola Médica. Em representação da Sociedade Portuguesa de Medicina Interna (SPMI).
  • Raquel Lucas EPIUnit, Instituto de Saúde Pública, Universidade do Porto. Em representação do Observatório Nacional das Doenças Reumáticas (ONDOR).
  • Jaime Branco Centro Hospitalar de Lisboa Ocidental. CEDOC/NOVA Escola Médica
  • Jorge Laíns Em representação da Sociedade Portuguesa de Medicina Física e de Reabilitação (SPMFR).
  • Mário Mascarenhas Em representação da Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo (SPEDM).
  • Susete Simões Em representação da Associação Portuguesa de Medicina Geral e Familiar (APMGF).
  • Viviana Tavares Em representação da Associação Nacional contra a Osteoporose (APOROS).
  • Óscar Lourenço Centro de Estudos e Investigação em Saúde, Universidade de Coimbra (CEISUC). Faculdade de Economia, Universidade de Coimbra, Coimbra, Portugal
  • José António Pereira da Silva Serviço de Reumatologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Clínica Universitária de Reumatologia, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal. Investigador Principal

DOI:

https://doi.org/10.32385/rpmgf.v32i6.11964

Keywords:

Risco de Fratura, FRAX, Osteoporose, DMO, DXA, Fraturas de Fragilidade, Orientações, Recomendações

Abstract

Objective: To establish Portuguese recommendations regarding the indications for ordering bone densitometry measurement to (DXA) and for starting treatment to prevent osteoporotic fractures. Methods: A multidisciplinary panel, representing a wide range of medical specialties and patient associations related to osteoporosis, as well as national experts in this field and in health economics, met to develop recommendations based on available evidence and expert consensus. Recently obtained data on the epidemiologic, economic and quality-of-life aspects of osteoporotic fractures in Portugal were used to support decisions. Results: Ten recommendations were developed covering the issues of indications for ordering DXA measurements and whom to treat with anti-fracture medications. Thresholds for assessment and intervention are based on the cost-effectiveness analysis of interventions at different thresholds of a ten-year probability of osteoporotic fractures, calculated with the Portuguese version of FRAX® (FRAX®Port), and taking into account Portuguese epidemiologic and economic data. Limitations of FRAX® are highlighted and guidance for appropriate adjustment is provided, when possible. Conclusions: Cost-effectiveness thresholds for DXA examination and drug intervention aiming at fragility fracture prevention are provided for the Portuguese population. These are practical, based on national epidemiological and economic data, evidence-based, and supported by a multidisciplinary panel of experts and scientific societies. Implementation of these recommendations has the possibility to assure the most effective use of health resources in the prevention of osteoporotic fractures in Portugal.

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Published

2016-11-01

Issue

Vol. 32 No. 6 (2016): Revista Portuguesa de Medicina Geral e Familiar

Section

Documents

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How to Cite

Portuguese recommendations for ordering bone densitometry measurement and indications for treatment to prevent osteoporotic fractures. (2016). Portuguese Journal of Family Medicine and General Practice, 32(6), 425-41. https://doi.org/10.32385/rpmgf.v32i6.11964

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