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Treatment of Osteoporosis in Long-Term Care

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References

  1. Luppa M, Luck T, Weyerer S, König HH, Brähler E, Riedel-Heller SG. Prediction of institutionalization in the elderly. A systematic review. Age Ageing. 2010;39:31–82.

    Article  PubMed  Google Scholar 

  2. Martinez-Reig M, Ahmad L, Duque G. The orthogeriatrics model of care: systematic review of predictors of institutionalization and mortality in post-hip fracture patients and evidence for interventions. J Am Med Dir Assoc. 2012;13:770–7.

    Article  PubMed  Google Scholar 

  3. Kruavit A, Chailurkit LO, Thakkinstian A, Sriphrapradang C, Rajatanavin R. Prevalence of vitamin D insufficiency and low bone mineral density in elderly Thai nursing home residents. BMC Geriatr. 2012;12:49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Rodondi A, Chevalley T, Rizzoli R. Prevalence of vertebral fracture in oldest old nursing home residents. Osteoporos Int. 2012;23:2601–6.

    Article  CAS  PubMed  Google Scholar 

  5. Gloth 3rd FM, Simonson W. Osteoporosis is underdiagnosed in skilled nursing facilities: a large-scale heel BMD screening study. J Am Med Dir Assoc. 2008;9:190–3.

    Article  PubMed  Google Scholar 

  6. Wright RM. Use of osteoporosis medications in older nursing facility residents. J Am Med Dir Assoc. 2007;8:453–7.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ooms ME, Vlasman P, Lips P, et al. The incidence of hip fractures in independent and institutionalized elderly people. Osteoporos Int. 1994;4:6–10.

    Article  CAS  PubMed  Google Scholar 

  8. Colon-Emeric C, Lyles KW, Levine DA, et al. Prevalence and predictors of osteoporosis treatment in nursing home residents with known osteoporosis or recent fracture. Osteoporos Int. 2007;18:553–9.

    Article  CAS  PubMed  Google Scholar 

  9. Hindmarsh D, Loh M, Finch CF, Hayen A, Close JC. Effect of comorbidity on relative survival following hospitalisation for fall-related hip fracture in older people. Australas J Ageing. 2014;33:E1–7.

    Article  PubMed  Google Scholar 

  10. Abimanyi-Ochom J, Watts JJ, Borgström F, Nicholson GC, Shore-Lorenti C, Stuart AL, Zhang Y, Iuliano S, Seeman E, Prince R, March L, Cross M, Winzenberg T, Laslett LL, Duque G, Ebeling PR, Sanders KM. Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS). Osteoporos Int. 2015;26:1781–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Cheng HY. Evidence-based prescribing of antiresorptive therapy for female nursing home residents with osteoporosis: how good is the evidence? J Am Geriatr Soc. 2006;54:375–6.

    Article  PubMed  Google Scholar 

  12. Duque G, Close JJ, de Jager JP, Ebeling PR, Inderjeeth C, Lord S, McLachlan AJ, Reid IR, Troen BR, Sambrook PN. Treatment for osteoporosis in Australian residential aged care facilities: consensus recommendations for fracture prevention. Med J Aust. 2010;193:173–9.

    PubMed  Google Scholar 

  13. Parikh S, Avorn J, Solomon DH. Pharmacological management of osteoporosis in nursing home populations: a systematic review. J Am Geriatr Soc. 2009;57:327–34.

    Article  PubMed  Google Scholar 

  14. Kucukler FK, Simsek Y, Turk AÇ, Arduc A, Guler S. Osteoporosis and silent vertebral fractures in nursing home resident elderly men in Turkey. J Clin Densitom. 2015. pii: S1094-6950(15)00120-1. doi:10.1016/j.jocd.2015.05.064.

    Google Scholar 

  15. Doherty DA, Sanders KM, Kotowicz MA, Prince RL. Lifetime and five-year age-specific risks of first and subsequent osteoporotic fractures in postmenopausal women. Osteoporos Int. 2001;12:16–23.

    Article  CAS  PubMed  Google Scholar 

  16. Chandler JM, Zimmerman SI, Girman CJ, et al. Low bone mineral density and risk of fracture in white female nursing home residents. JAMA. 2000;284:972–7.

    Article  CAS  PubMed  Google Scholar 

  17. Greenspan SL, Myers ER, Kiel DP, et al. Fall direction, bone mineral density, and function: risk factors for hip fracture in frail nursing home elderly. Am J Med. 1998;104:539–45.

    Article  CAS  PubMed  Google Scholar 

  18. Gloth 3rd FM. Osteoporosis in long term care. Part 1 of 2: recognizing bone and beyond. Director. 2004;12:175–6, 179–80.

    PubMed  Google Scholar 

  19. Broe KE, Hannan MT, Kiely DK, et al. Predicting fractures using bone mineral density: a prospective study of long-term care residents. Osteoporos Int. 2000;11:765–71.

    Article  CAS  PubMed  Google Scholar 

  20. Zimmerman SI, Girman CJ, Buie VC, et al. The prevalence of osteoporosis in nursing home residents. Osteoporos Int. 1999;9:151–7.

    Article  CAS  PubMed  Google Scholar 

  21. Nakamura K, Takahashi S, Oyama M, Oshiki R, Kobayashi R, Saito T, Yoshizawa Y, Tsuchiya Y. Prior nonhip limb fracture predicts subsequent hip fracture in institutionalized elderly people. Osteoporos Int. 2010;21:1411–6.

    Article  CAS  PubMed  Google Scholar 

  22. Girman CJ, Chandler JM, Zimmerman SI, Martin AR, Hawkes W, Hebel JR, Sloane PD, Magaziner J. Prediction of fracture in nursing home residents. J Am Geriatr Soc. 2002;50:1341–7.

    Article  PubMed  Google Scholar 

  23. Zimmerman S, Chandler JM, Hawkes W, et al. Effect of fracture on the health care use of nursing home residents. Arch Intern Med. 2002;162:1502–8.

    Article  PubMed  Google Scholar 

  24. Ray NF, Chan JK, Thamer M, et al. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res. 1997;12:24–35.

    Article  CAS  PubMed  Google Scholar 

  25. McClung MR. To FRAX or not to FRAX. J Bone Miner Res. 2012;27:1240–2.

    Article  PubMed  Google Scholar 

  26. Hajjar RR, Kamel HK. Osteoporosis for the home care physician. Part 1: etiology and current diagnostic strategies. J Am Med Dir Assoc. 2004;5:192–6.

    Article  PubMed  Google Scholar 

  27. Schousboe JT, Ensrud KE, Nyman JA, et al. Universal bone densitometry screening combined with alendronate therapy for those diagnosed with osteoporosis is highly cost-effective for elderly women. J Am Geriatr Soc. 2005;53:1697–704.

    Article  PubMed  Google Scholar 

  28. Gupta G, Aronow WS. Underuse of procedures for diagnosing osteoporosis and of therapies for osteoporosis in older nursing home residents. J Am Med Dir Assoc. 2003;4:200–2.

    Article  PubMed  Google Scholar 

  29. Dugard MN, Jones TJ, Davie MW. Uptake of treatment for osteoporosis and compliance after bone density measurement in the community. J Epidemiol Community Health. 2010;64:518–22.

    Article  PubMed  Google Scholar 

  30. Colón-Emeric CS, Lyles KW, House P, Levine DA, Schenck AP, Allison J, Gorospe J, Fermazin M, Oliver K, Curtis JR, Weissman N, Xie A, Saag KG. Randomized trial to improve fracture prevention in nursing home residents. Am J Med. 2007;120:886–92.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Elliott ME, Binkley NC, Carnes M, et al. Fracture risks for women in long-term care: high prevalence of calcaneal osteoporosis and hypovitaminosis D. Pharmacotherapy. 2003;23:702–10.

    Article  PubMed  Google Scholar 

  32. Saliba D, Solomon D, Rubenstein L, et al. Quality indicators for the management of medical conditions in nursing home residents. J Am Med Dir Assoc. 2004;5:297–309.

    Article  PubMed  Google Scholar 

  33. Duque G, Mallet L, Roberts A, et al. Quebec Symposium for the Treatment of Osteoporosis in Long-Term Care. To treat or not to treat, that is the question: proceedings of the Quebec Symposium for the Treatment of Osteoporosis in Long- term Care Institutions, Saint-Hyacinthe, Quebec, November 5, 2004. J Am Med Dir Assoc. 2006;7:435–41.

    Article  PubMed  Google Scholar 

  34. Kamel HK. Underutilization of calcium and vitamin D supplements in an academic long- term care facility. J Am Med Dir Assoc. 2004;5:98–100.

    Article  PubMed  Google Scholar 

  35. Residential Aged Care in Australia. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737422896. Last visited 22 July 2015.

  36. Bergman H, Montambault J. Services d’hébergement. In: Arcand M, Hébert R, editors. Précis pratique de gériatrie. 2nd ed. St-Hyacinthe/Paris: Edisem/Maloine; 1997.

    Google Scholar 

  37. Reginster JY. Antifracture efficacy of currently available therapies for postmenopausal osteoporosis. Drugs. 2011;71:65–78.

    Article  CAS  PubMed  Google Scholar 

  38. Papaioannou A, Kennedy CC, Dolovich L, et al. Patient adherence to osteoporosis medications. Problems, consequences and management strategies. Drugs Aging. 2007;24:35–55.

    Article  Google Scholar 

  39. Caro JJ, Ishak KJ, Huybrechts KF, et al. The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int. 2004;15:1003–8.

    Article  PubMed  Google Scholar 

  40. Zarowitz BJ, Cheng LI, Allen C, O’Shea T, Stolshek B. Osteoporosis prevalence and characteristics of treated and untreated nursing home residents with osteoporosis. J Am Med Dir Assoc. 2015;16:341–8.

    Article  PubMed  Google Scholar 

  41. Demontiero O, Herrmann M, Duque G. Supplementation with vitamin D and calcium in long-term care residents. J Am Med Dir Assoc. 2011;12:190–4.

    Article  PubMed  Google Scholar 

  42. Hathcock JN, Shao A, Vieth R, et al. Risk assessment for vitamin D. Am J Clin Nutr. 2007;85:6–18.

    CAS  PubMed  Google Scholar 

  43. Rolland Y, de Souto Barreto P, Abellan Van Kan G, Annweiler C, Beauchet O, Bischoff-Ferrari H, Berrut G, Blain H, Bonnefoy M, Cesari M, Duque G, Ferry M, Guerin O, Hanon O, Lesourd B, Morley J, Raynaud-Simon A, Ruault G, Souberbielle JC, Vellas B, French Group of Geriatrics and Nutrition. Vitamin D supplementation in older adults: searching for specific guidelines in nursing homes. J Nutr Health Aging. 2013;17:402–12.

    Article  CAS  PubMed  Google Scholar 

  44. Hamid Z, Riggs A, Spencer T, et al. Vitamin D deficiency in residents of academic long-term care facilities despite having been prescribed vitamin D. J Am Med Dir Assoc. 2007;8:71–5.

    Article  PubMed  Google Scholar 

  45. Jachna CM, Shireman TI, Whittle J, et al. Differing patterns of antiresorptive pharmacotherapy in nursing facility residents and community dwellers. J Am Geriatr Soc. 2005;53:1275–81.

    Article  PubMed  Google Scholar 

  46. Parikh S, Mogun H, Avorn J, Solomon DH. Osteoporosis medication use in nursing home patients with fractures in 1 US state. Arch Intern Med. 2008;168:1111–5.

    Article  PubMed  Google Scholar 

  47. Fleurence RL, Iglesias CP, Johnson JM. The cost effectiveness of bisphosphonates for the prevention and treatment of osteoporosis: a structured review of the literature. Pharmacoeconomics. 2007;25:913–33.

    Article  CAS  PubMed  Google Scholar 

  48. Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review. J Am Med Dir Assoc. 2015;16:535.e1–12. doi:10.1016/j.jamda.2015.03.003. Epub 2015 Apr 11.

    Article  Google Scholar 

  49. Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, Rigby D, Gnjidic D, Del Mar CB, Roughead EE, Page A, Jansen J, Martin JH. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175:827–34.

    Article  PubMed  Google Scholar 

  50. Deane A, Constancio L, Fogelman I, et al. The impact of vitamin D status on changes in bone mineral density during treatment with bisphosphonates and after discontinuation following long- term use in post-menopausal osteoporosis. BMC Musculoskelet Disord. 2007;8:3.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Nguyen ND, Frost SA, Center JR, et al. Development of prognostic nomograms for individualizing 5-year and 10-year fracture risks. Osteoporos Int. 2008;19:1431–44.

    Article  CAS  PubMed  Google Scholar 

  52. Chen JS, Sambrook PN, Simpson JM, et al. A selection strategy was developed for fracture reduction programs in frail older people. J Clin Epidemiol. 2010;63:679–85.

    Article  PubMed  Google Scholar 

  53. Johnson K, Suriyaarachchi P, Kakkat M, Boersma D, Gunawardene P, Demontiero O, Tannenbaum C, Duque G. Yield and cost-effectiveness of laboratory testing to identify metabolic contributors to falls and fractures in older persons. Arch Osteoporos. 2015;10:226.

    Article  PubMed  Google Scholar 

  54. Singh S, Sun H, Anis AH. Cost-effectiveness of hip protectors in the prevention of osteoporosis related hip fractures in elderly nursing home residents. J Rheumatol. 2004;31:1607–13.

    PubMed  Google Scholar 

  55. Cameron ID, Kurrle SE, Quine S, Sambrook PN, March L, Chan DK, Lockwood K, Cook B, Schaafsma FF. Improving adherence with the use of hip protectors among older people living in nursing care facilities: a cluster randomized trial. J Am Med Dir Assoc. 2011;12:50–7.

    Article  PubMed  Google Scholar 

  56. Abizanda P, López MD, García VP, Estrella Jde D, da Silva González Á, Vilardell NB, Torres KA. Effects of an Oral Nutritional Supplementation Plus Physical Exercise Intervention on the Physical Function, Nutritional Status, and Quality of Life in Frail Institutionalized Older Adults: The ACTIVNES Study. J Am Med Dir Assoc. 2015;16:439.e9–16. doi:10.1016/j.jamda.2015.02.005.

    Article  Google Scholar 

  57. Silva RB, Eslick GD, Duque G. Exercise for falls and fracture prevention in long term care facilities: a systematic review and meta-analysis. J Am Med Dir Assoc. 2013;14:685–9.

    Article  PubMed  Google Scholar 

  58. Mocanu V, Vieth R. Three-year follow-up of serum 25-hydroxyvitamin D, parathyroid hormone, and bone mineral density in nursing home residents who had received 12 months of daily bread fortification with 125 μg of vitamin D3. Nutr J. 2013;12:137.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Verhoeven V, Vanpuyenbroeck K, Lopez-Hartmann M, Wens J, Remmen R. Walk on the sunny side of life – epidemiology of hypovitaminosis D and mental health in elderly nursing home residents. J Nutr Health Aging. 2012;16:417–20.

    Article  CAS  PubMed  Google Scholar 

  60. Drinka PJ, Krause PF, Nest LJ, Goodman BM. Determinants of vitamin D levels in nursing home residents. J Am Med Dir Assoc. 2007;8:76–9.

    Article  PubMed  Google Scholar 

  61. Durvasula S, Sambrook PN, Cameron ID. Factors influencing adherence with therapeutic sunlight exposure in older people in intermediate care facilities. Arch Gerontol Geriatr. 2012;54:e234–41.

    Article  PubMed  Google Scholar 

  62. Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B. Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med. 2006;166:424–30.

    CAS  PubMed  Google Scholar 

  63. Greenspan SL, Schneider DL, McClung MR, et al. Alendronate improves bone mineral density in elderly women with osteoporosis residing in long-term care facilities. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2002;136:742–6.

    Article  CAS  PubMed  Google Scholar 

  64. McHorney CA, Schousboe JT, Cline RR, et al. The impact of osteoporosis medication beliefs and side-effect experiences on non-adherence to oral bisphosphonates. Curr Med Res Opin. 2007;23:3137–52.

    Article  CAS  PubMed  Google Scholar 

  65. Greenspan SL, Perera S, Ferchak MA, Nace DA, Resnick NM. Efficacy and safety of single-dose zoledronic Acid for osteoporosis in frail elderly women: a randomized clinical trial. JAMA Intern Med. 2015;175:913–21.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Boonen S, Adachi JD, Man Z, Cummings SR, Lippuner K, Törring O, Gallagher JC, Farrerons J, Wang A, Franchimont N, San Martin J, Grauer A, McClung M. Treatment with denosumab reduces the incidence of new vertebral and hip fractures in postmenopausal women at high risk. J Clin Endocrinol Metab. 2011;96:1727–36.

    Article  CAS  PubMed  Google Scholar 

  67. Diab DL, Watts NB. Denosumab in osteoporosis. Expert Opin Drug Saf. 2014;13:247–53.

    Article  CAS  PubMed  Google Scholar 

  68. Reid IR. Short-term and long-term effects of osteoporosis therapies. Nat Rev Endocrinol. 2015;11:418–28.

    Article  CAS  PubMed  Google Scholar 

  69. Khan AA, Morrison A, Hanley DA, Felsenberg D, McCauley LK, O’Ryan F, Reid IR, Ruggiero SL, Taguchi A, Tetradis S, Watts NB, Brandi ML, Peters E, Guise T, Eastell R, Cheung AM, Morin SN, Masri B, Cooper C, Morgan SL, Obermayer-Pietsch B, Langdahl BL, Al Dabagh R, Davison KS, Kendler DL, Sándor GK, Josse RG, Bhandari M, El Rabbany M, Pierroz DD, Sulimani R, Saunders DP, Brown JP, Compston J, International Task Force on Osteonecrosis of the Jaw. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res. 2015;30:3–23.

    Article  PubMed  Google Scholar 

  70. Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster DW, Ebeling PR, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O’Keefe R, Papapoulos S, Howe TS, van der Meulen MC, Weinstein RS, Whyte MP. Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2014;29:1–23.

    Article  PubMed  Google Scholar 

  71. Inderjeeth CA, Foo AC, Lai MM, Glendenning P. Efficacy and safety of pharmacological agents in managing osteoporosis in the old old: review of the evidence. Bone. 2009;44:744–51.

    Article  CAS  PubMed  Google Scholar 

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Duque, G., Suriyaarachchi, P., Gunawardene, P., Demontiero, O. (2016). Treatment of Osteoporosis in Long-Term Care. In: Duque, G., Kiel, D. (eds) Osteoporosis in Older Persons. Springer, Cham. https://doi.org/10.1007/978-3-319-25976-5_14

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