Endocrine Abstracts

Treatment of osteoporosis is all about prevention of fractures. It relies on a combination of approaches, including adjustments to the patient’s diet and lifestyle, pharmacological therapy, and patient education. Changes to the patient’s diet and lifestyle typically involve: optimizing calcium and vitamin D intake and exercise levels, cessation of smoking and reducing alcohol consumption. Pharmacological therapies used to treat osteoporosis by reducing the fracture risk include bisphosphonates or the RANK ligand inhibitor denosumab. Nurses have an important role in educating patients about fracture risk, the benefits of lifestyle modifications for maintaining bone health and the treatment options available, including side effects and the importance of adherence. In the current Dutch osteoporosis guidelines, it is recommended that hospitals appoint a specialised fracture nurse for the organisation and coordination of osteoporosis care. These specialised nurses provide care relating to case finding, risk evaluation, prevention, diagnosis, treatment and follow up. Each of these steps is essential and an insufficient implementation can result in suboptimal fracture prevention. Their main area of expertise is the recognition of risk factors. These risk factors can be related to the bone itself, a fall or the patient’s lifestyle. Some of these factors can be influenced, some cannot. Patients need to have a good understanding of their diagnosis and fracture risk to make informed choices with regard to pharmacological treatment and/or lifestyle change.