CME/CE Quiz

Fracture Prevention in Osteoporosis

Accreditation:

The University of Cincinnati College of Medicine designates this educational activity for a maximum of two (2) AMA PRA Category 1 CME Creditsâ„¢. Physicians should only claim credit commensurate with the extent of their participation in this activity.

The University of Cincinnati College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor medical education for physicians.

The GMR Group-Health Insights is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation and is a provider approved by the California Board of Registered Nursing, California Provider # CEP 12643.

The GMR Group-Health Insights is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program offers a total of 1.75 contact hours or 0.175 CEUs. ACPE # 404-000-06-001-H01.

Instructions

After reading "Fracture Prevention in Osteoporosis" please complete the program evaluation and fill out the answer key for each of the following questions.

1. According to the National Osteoporosis Foundation, how many individuals in the United States have, or are at risk for, osteoporosis?

• 20 million
• 50 million

2. Osteoporosis has been estimated to result in how many fragility fractures yearly?

• 1.5 million
• 5 million

3. The majority of osteoporosis-related fractures are _____.

• nonvertebral
• infection related

4. Absent osteoporosis, bone turnover _____.

• favors bone resorption
• ceases

5. By 2020, yearly healthcare spending for osteoporotic-related fracture in the United States is expected to reach _____.

• $21 billion to $27 billion
• $70 billion to $81 billion

6. Risk factors for osteoporosis-related fracture include which of the following?

• Low body mass index
• All of the above

7. Which of the following is a possible physical sign of vertebral fracture?

• Arm span loss
• Leg length loss

8. Which of the following is a biochemical marker of bone formation?

• C-telopeptide
• Deoxypyridinoline

9. The World Health Organization defines the threshold for a diagnosis of osteoporosis as a T-score of less than _____.

• -1
• -3

10. Medicare covers bone mineral density (BMD) testing every 2 years for which of the following groups?

• Individuals with nonvertebral abnormalities demonstrated by x-ray.
• All of the above

11. In the National Osteoporosis Risk Assessment study, the presence of osteopenia increased the risk for fracture by _____.

• 4-fold
• 6-fold

12. In the Study of Osteoporotic Fracture trial, the risk for hip fracture in women over the age of 65 years increased _____.

• particularly rapidly in smokers
• as caffeine use decreased

13. The National Osteoporosis Foundation advocates starting pharmacotherapy to reduce fracture risk in which groups of women?

• T-score <-1.5 by hip DXA with 1 or more risk factors.
• All of the above

14. Alendronate has been shown to reduce the risk for vertebral and nonvertebral fracture _____.

• in men and women
• in men and women without prior fractures

15. After starting therapy, risedronate reduces the risk for vertebral and nonvertebral fracture within _____.

• 4 months
• 12 months

16. In reducing the risk for nonvertebral fracture, calcitonin has been shown to be less effective than either _____.

• alendronate or raloxifene
• risedronate or raloxifene

17. A study using "real-world" data from the Protocare Sciences Integrated Medical and Pharmaceutical Claims Database demonstrated that, compared with calcitonin or alendronate treatment, risedronate reduced the adjusted risk for nonvertebral fracture at 6 months by _____.

• 54%
• 71%

18. The results of an observational study using data from the Protocare Sciences Database indicated that the annual nonvertebral fracture-related medical cost in patients treated with risedronate is _____.

• $210 less than that for alendronate
• All of the above

19. In the study by Miller, using data from the Protocare Sciences Database, the risk for gastrointestinal (GI) side effects in patients with a history of GI events was _____.

• 49% higher with alendronate versus risedronate
• 44% lower with alendronate versus risedronate

20. In the observational cost analysis study by Kane, the annual direct medical costs for GI events in patients treated with risedronate were _____.

• higher than those in patients treated with calcitonin
• about $4000 lower than in patients treated with alendronate

GOAL

To enhance understanding of current practices in fracture prevention.

TARGET AUDIENCE

Managed care pharmacy directors, medical directors, and other managed care executives . . .

LEARNING OBJECTIVES

Upon completion of this activity, participants will be able to:

• Define the current management practices for osteoporosis–nonpharmacologic, pharmacologic
• Define the various drug classes used to prevent/treat osteoporosis and appropriate utilization of these agents
• Determine the impact of the Medicare Modernization Act legislation as it relates to osteoporosis management

There is no fee for this program.

Expiration date: 05-31-07

FUNDING

This publication was made possible by funding from The Alliance for Better Bone Health, P&G/Sanofi-Aventis.

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The contents of this supplement may include information regarding the use of products that may be inconsistent outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

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