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January 17, 2017

Osteoporosis and Fracture Risk Evaluation and Management: Shared Decision Making in Clinical Practice

Author Affiliations
  • 1Osteoporosis and Bone Health Services, Mercy Health, Cincinnati, Ohio
  • 2Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
  • 3Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
JAMA. 2017;317(3):253-254. doi:10.1001/jama.2016.19087

Fractures due to osteoporosis represent a serious and costly public health problem, leading to disability and increased mortality risk.1 For postmenopausal women, osteoporotic fractures are more common than stroke, myocardial infarction, and breast cancer combined.2 A fracture can be a life-changing event and may represent a significant threat to personal independence. Although osteoporosis is commonly defined as “a skeletal disorder characterized by decreased bone strength predisposing to an increased risk of fracture,” it is fracture that is the important end result. A more pragmatic definition is “high risk of fracture, due at least in part to increased skeletal fragility.” Primary care clinicians should be comfortable evaluating, preventing, and treating osteoporosis and related risks (Box).