QUALITY TOOL BOX

OSTEOPOROSIS

GENERAL & MEDICAL REHABILITATION COUNCIL [GMRC]

Osteoporosis QTB – People & Process

GMRC Chair: Michael Stubblefield, MDPerformance Metrics Committee Chair: Elizabeth Sandel, MD

CHAIR-ELECT & LEAD: K. R. PODURI, MD

SUBJECT MATTER EXPERTS: GOPI KASTURI, MDLESLIE MORIS, MD

AAPM&R Clinical Practice Guidelines Committee Chair: Richard Zorowitz, MDAAPM&R Evidence Committee, Chair: Thiru Annaswamy, MDPMC Liaison TO GMRC: DEEPTHI SAXENA, MD

CLINICAL PRACTICE GUIDELINES [CPG]

Management of Osteoporosis in men

AHRQ National Guideline Clearing House

Screening for osteoporosis in the adult U.S. population: American College of Preventive Medicine, ACPM) Position statement on preventive practice. Am J Preventive Medicine 2009 Apr;36[4]:366-75.

CPG

Osteoporosis: Prevention and treatment. Ann Arbor (MI): University of Michigan Health System; 2011 Dec. 16 p. University of Michigan Health System (UMHS).

Screening for osteoporosis: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine 2011 Mar 1:154(5): 356-64.

1. CORE CONSTRUCTS - Symptoms

Pain and disability (A, B)

A. OSWESTRY DISABILITY INDEX< = 5 minutesFree. No trainingPRO. 10 sections with 6 items each.ICF Domains - Body Structure, Body Function, Activity, Participation, Environment.

CORE CONSTRUCTS - Symptoms

B. PAIN ROLAND-MORRIS DISABILITY QUESTIONNAIRE < = 5/ 10/ 30 min (based on no. of items used, 11, 18 or 24 min.)Free. No trainingPROICF Domain - Body Function

2. CORE CONSTRUCTS - Mobility

EXERCISE(4) (5) © 10 METER WALK TEST < 5 minFreeNo trainingPBAICF Domain - Activity

3. CORE CONSTRUCTS – Balance (Falls)A. Tinetti (Prevention and screening tool) 10 to 15 minutesFreeNo trainingPRO. ICF Domains – Activity and Participation

B. Four Step Square Test (FFST) < 5 minutesFreeNo trainingPBA. ICF Domains – Activity

CORE CONSTRUCTS – Balance (Falls)

C. BALANCE

RIVERMEAD MOBILITY INDEX< 5 minFreeNo training PRO. 15 itemsICF Domain - Activity

CORE CONSTRUCTS – Fracture Prevention

D. Fracture Risk (F)

FRAX – Though BMD or T score are needed, the system generates a score with interpretation without these. BMI can be used per tool online. – Reference PATO study.

E. Diet/ Alcohol/ Smoking

4. CORE CONSTRUCTS - Participation – QOL

Participation/Social roles (6) (G)

A. LONDON HANDICAP SCALE < 5 min, free, no training.PRO. 6-point scaleICF Domain –Participation

CORE CONSTRUCTS - Participation – QOL

B. Quality of Life WHO QOL BREF10 to 15 min.FreeNo trainingPRO. 26 ItemsDomains - Activity, Participation and Environment.

Quality METRICS

AAPM&R - PQRS Measures40 and 41

40. Osteoporosis: Management Following Fracture of Hip, Spine or Distal Radius for Men and Women Aged 50 Years and Older 41. Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older

REFERENCES