RESUMO
OBJECTIVE: To update the recommendations on osteoporosis (OP) of the Spanish Society of Rheumatology (SER) based on the best possible evidence. METHODS: A panel of nine expert rheumatologists in OP was created, previously selected by the SER through an open call. The phases of the work were: identification of the key areas for updating the previous consensus, analysis and synthesis of the scientific evidence (using the SIGN levels of evidence) and formulation of recommendations based on this evidence and consensus techniques. RESULTS: This revision of the recommendations implies an update in the diagnostic evaluation and treatment of OP. It proposes some criteria to consider the high risk of fracture and some indications to start treatment. The recommendations also address issues related to the safety of treatments and the management of special situations such as inflammatory diseases and treatment with glucocorticoids. CONCLUSIONS: We present an update of SER recommendations on OP.
Assuntos
Osteoporose/diagnóstico , Osteoporose/terapia , HumanosRESUMO
OBJECTIVE: To assess therapeutic compliance in osteoporosis in women in a Primary Care (PC) setting. PATIENTS AND METHODS: Observational, descriptive, cross-sectional and multicenter study, conducted in PC centers of the 17 Spanish Autonomous Regions. 1,649 women who had initiated treatment for osteoporosis at least 3 months before entering the study were recruited. To assess therapeutic compliance, two questionnaires, the Haynes-Sackett or self-communicated compliance test (AC) and the Morisky-Green test (MG) were used. RESULTS: Patients' mean age (± SD) was 66.59 years (9.5) and the mean time since diagnosis was 5.08 years (4.87). Bisphosphonates were the most precribed drugs (82% of the patients) and only 52% of the patients were taking calcium and vitamin D supplements. Analysis of the therapeutic compliance level shows that, as per the MG test, 68.7% of the patients were non-compliers, and 11.2% were non-compliers as per the AC test. CONCLUSIONS: An important percentage of women with post-menopausal osteoporosis in Spain's PC setting show a high level of non-compliance.
Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Adesão à Medicação/estatística & dados numéricos , Osteoporose Pós-Menopausa/tratamento farmacológico , Idoso , Cálcio/uso terapêutico , Estudos Transversais , Difosfonatos/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Atenção Primária à Saúde , Inquéritos e Questionários , Vitamina D/uso terapêuticoRESUMO
OBJECTIVE: Due to increasing improvement in the diagnosis, evaluation and management of osteoporosis and the development of new tools and drugs, the Spanish Society of Rheumatology (SER) has promoted the development of recommendations based on the best evidence available. These recommendations should be a reference to rheumatologists and other health professionals involved in the treatment of patients with osteoporosis. METHODS: Recommendations were developed following a nominal group methodology and based on a systematic review. The level of evidence and degree of recommendation were classified according to the model proposed by the Center for Evidence Based Medicine at Oxford. The level of agreement was established through Delphi technique. Evidence from previous consensus and available clinical guidelines was used. RESULTS: We have produced recommendations on diagnosis, evaluation and management of osteoporosis. These recommendations include the glucocorticoid-induced osteoporosis, premenopausal and male osteoporosis. CONCLUSIONS: We present the SER recommendations related to the biologic therapy risk management.
Assuntos
Osteoporose , Absorciometria de Fóton , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico , Feminino , Humanos , Masculino , Osteoporose/complicações , Osteoporose/diagnóstico , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/diagnóstico , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/terapia , Fatores de Risco , EspanhaRESUMO
OBJECTIVES: To describe the clinical and epidemiological characteristics of patients included in the National Register of Paget's disease. METHODS: A Register of patients with Paget disease (PD), radiologically confirmed, and pertaining to 25 hospitals was analysed. Clinical and epidemiological data were collected, including age, sex, date and presentations at time of diagnosis, treatment, quality of life (QL) (EuroQol 5D) and perceived health, environmental factors (profession, history of measles, contact with animals, dairy consumption, housing conditions, place of birth and address) and family history (PD history, origin of the ancestors, number of children). We conducted a statistical description of the data. RESULTS: The register included 602 patients with an average age of 62±11 years and a predominance of male (55%). Of the patients included, 79% showed symptoms at the time of diagnosis, mainly pain (83%); 82% had received treatment, mainly bisphosphonates (47% more than one drug). Despite treatment, a significant proportion had limitations in their QL, especially related to pain (64%), mobility (47%) and anxiety/depression (33%). Most of the patients had been exposed to situations which were considered as risk factors. Of the patients included, 14% had family history of PD and 1.5% had children with PD. The ancestors of the familial cases came more frequently from Avila, Salamanca, La Coruña and Malaga. CONCLUSIONS: The pain and the limitation of mobility decrease the QL of patients with PD despite treatment. Frequently, patients have a history of exposure to risk factors.