Community-based Standardized Management Algorithm of Primary Osteoporosis

doi:10.12114/j.issn.1007-9572.2019.00.108

Abstract

Abstract: In order to standardize management of primary osteoporosis in the community，improve the capability of early screening，diagnose，treatment and health management，a community-based standardized management algorithm of primary osteoporosis is formulated by the Chinese Medical Doctor Association （CMDA）'s General Practitioners Sub-association，through a discussion of domestic experts based on the domestic and international latest evidence-based medical evidence，the condition of domestic community health service as well as protocols and guidelines associated with the prevention and treatment of osteoporosis.This management algorithm includes 4 parts，screening，diagnose，management （health records establishment，life-style guidance，health education，the application of bone health basic supplements，medication，fall prevention，follow-up） and referral，design the management flow diagram，standardize the contents and process of management.The release of this management algorithm is of great significance to improve the diagnosis and treatment level and strength the prevention and control of osteoporosis in China.

Key words: Osteoporosis, Community health services, Standardized management

摘要： 为规范原发性骨质疏松症的社区管理，提高早期筛查、规范诊治、健康管理水平，中国医师协会全科医师分会于2018年组织国内有关专家，根据循证医学证据、我国社区卫生服务现状、骨质疏松症防治相关方案及指南等，制订了《原发性骨质疏松症社区规范化管理方案》。本方案主要包含骨质疏松症筛查、诊断、管理（建立健康档案、生活方式指导、系统健康教育、骨健康基本补充剂的应用、药物治疗、跌倒的预防、随访）、转诊四部分内容，制定社区规范化管理流程图，规范管理内涵及流程。本方案的发布对提高我国社区骨质疏松症的防治水平有重要意义。

关键词: 骨质疏松症, 社区卫生服务, 规范化管理

Chinese Medical Doctor Association （CMDA）'s General Practitioners Sub-association. Community-based Standardized Management Algorithm of Primary Osteoporosis[J]. Chinese General Practice, 2019, 22(11): 1251-1257. DOI: 10.12114/j.issn.1007-9572.2019.00.108.
中国医师协会全科医师分会. 原发性骨质疏松症社区规范化管理方案[J]. 中国全科医学, 2019, 22(11): 1251-1257. DOI: 10.12114/j.issn.1007-9572.2019.00.108.

References

［1］中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊疗指南（2017）［J］．中国全科医学，2017，20（32）：3963-3982．DOI：10.3969/j.issn.1007-9572.2017.00.118.
Chinese Society of Osteoporosis and Bone Mineral Research.Guidelines for the diagnosis and treatment of primary osteoporosis （2017）［J］．Chinese General Practice，2017，20（32）：3963-3982．DOI：10.3969/j.issn.1007-9572.2017.00.118.
［2］KEENE G S，PARKER M J，PRYOR G A.Mortality and morbidity after hip fractures［J］．BMJ，1993，307（6914）：1248-1250.
［3］OSNES E K，LOFTHUS C M，MEYER H E，et al．Consequences of hip fracture on activities of daily life and residential needs ［J］．Osteoporos Int，2004，15（7）：567-574．DOI：10.1007/s00198-003-1583-0.
［4］BRECHER L S，POMERANTZ S C，SNYDER B A，et al．Osteoporosis prevention project：a model multidisciplinary educational intervention［J］．J Am Osteopath Assoc，2002，102（6）：327-335.
［5］MAJUMDAR S R，BEAUPRE L A，HARLEY C H，et al．Use of a case manager to improve osteoporosis treatment after hip fracture：results of a randomized controlled trial［J］．Arch Intern Med，2007，167（19）：2110-2115．DOI：10.1001/archinte.167.19.2110.
［6］IOF one-minute osteoporosis risk test［EB/OL］．［2019-03-05］．http：//www.osteofound.org/osteoporosis/risk_test.html.
［7］KOH L K，SEDRINE W B，TORRALBA T P，et al．A simple tool to identify Asian women at increased risk of osteoporosis［J］．Osteoporos Int，2001，12（8）：699-705.
［8］GENANT H K，WU C Y，VAN KUIJK C，et al．Vertebral fracture assessment using a semiquantitative technique ［J］．J Bone Mineral Res，1993，8（9）：1137-1148.
［9］王临虹，夏维波，林华.骨质疏松症防治指南［M］．北京：北京大学医学出版社，2017.
［10］中国营养学会.中国居民膳食营养素参考摄入量［M］．北京：科学出版社，2014.
［11］黄庆，陈承志，张遵真.中国成人吸烟与骨密度相关性的Meta分析［J］．现代预防医学，2016，43（3）：475-481.
［12］国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告（2015年）［M］．北京：人民卫生出版社.2015.
［13］Fracture risk assessment tool［EB/OL］．［2019-03-05］．http：//www.sheffield.ac.uk/FRAX/index.aspx.

[1]	YAO Yuzhong, MA Xiaojun, SONG Huan, ZHONG Yu. The Management Effect of Diabetes "1358 model" on Community Diabetes Patients Based on "Precision Management Combining General Care and Specialty Care" [J]. Chinese General Practice, 2023, 26(34): 4308-4314.
[2]	QIN Fengyin, ZHANG Qishan, LAI Jinjia, HUANG Yimin, HAN Guoyin, SUN Xinglan, WANG Fen, TAN Yibing. Current Status and Influencing Factors of the Intention to Screen for High-risk Stroke among Community Residents in Guangdong [J]. Chinese General Practice, 2023, 26(34): 4283-4289.
[3]	LI Dianjiang, PAN Enchun, SUN Zhongming, WEN Jinbo, WANG Miaomiao, WU Ming, SHEN Chong. The Current Status and Influencing Factors of Clinical Inertia in Type 2 Diabetes Patients in Community [J]. Chinese General Practice, 2023, 26(34): 4296-4301.
[4]	HUANG Jinling, ZENG Zhirong. The Logic and Trend of Urban Community Health Service Policies in China [J]. Chinese General Practice, 2023, 26(34): 4239-4245.
[5]	YANG Hui, HU Ruwei, LIU Ruqing, LU Junfeng, WU Jinglan. Relationship between Community Health Service Experience and Glycemic Control Outcomes in Patients with Diabetes Mellitus [J]. Chinese General Practice, 2023, 26(34): 4290-4295.
[6]	XU Jian, DAI Fangfang, PAN Wenlei, HUANG Qian, LU Ping, WANG Jianfeng, JIA Huan, YANG Yuqi, HUANG Jiaoling. Visual Analysis of Hotspots and Cutting-edge Trends of Community TCM Service Research in China in the Context of Healthy China [J]. Chinese General Practice, 2023, 26(34): 4343-4350.
[7]	LI Qianqian, CHEN Xunrui, ZHANG Wenying, YUAN Haihua, ZHANG Yanjie, JIANG Bin, LIU Feng. Demand and Influencing Factors for Community Health Services during Chemotherapy of Patients with Advanced Cancer [J]. Chinese General Practice, 2023, 26(33): 4173-4180.
[8]	YIN Zhaoxia, MAO Lidong, ZHANG Baoshuang, HUANG Yin, FENG Yang, WANG Yunfei. Spectrum of Outpatient Illnesses in Children Contracting Family Doctor Services in Shenzhen's Community Settings and Related Implications for Standardized Residency Training of General Practitioners [J]. Chinese General Practice, 2023, 26(33): 4218-4224.
[9]	YU Dehua. Scientific Research Conception Guided by General Practice Thinking [J]. Chinese General Practice, 2023, 26(31): 3872-3876.
[10]	ZHOU Yingda, ZHUO Shuxiong, YANG Xi, JIN Hua, YU Dehua. Implementation Status and Strategy Research on the Construction of Clinical Pathways for Diagnosis and Treatment of Medically Unexplained Disease in Community General Practice [J]. Chinese General Practice, 2023, 26(31): 3939-3944.
[11]	HONG Yuchun, WU Hua, DU Yishan, LI Shuran, SUN Wenmin, YE Mingyu, ZHANG Yongjian, LI Yang. Development of General Practice Diagnostic Terminology and Coding and Empirical Study on Its Application [J]. Chinese General Practice, 2023, 26(31): 3896-3901.
[12]	ZHOU Dongdong, GE Xuhua. The Evaluation Index of Post Competence of General Practitioners in Less-developed Areas [J]. Chinese General Practice, 2023, 26(31): 3908-3914.
[13]	HU Jingyi, HONG Jing, GUO Xiaodong, ZHANG Xiaohong, MO Ning, ZHOU Xiaocui, YU Qin, ZHOU Minhua, SUN Yan, NI Liu, SHI Xiaoli, SU Xiaoqing, LI Yuqian. Efficacy of Community-involved Hospice Care for Patients with Advanced Cancer: a Meta-analysis [J]. Chinese General Practice, 2023, 26(28): 3573-3584.
[14]	TAO Lu, LI Sha, DING Yaping, ZONG Qianxing, GAO Shiying, NIE Zuoting, CHEN Long, WU Yan, YANG Rumei. Association between Self-rated Health and Frailty among Community-dwelling Older Adults: the Moderating Role of Apathy [J]. Chinese General Practice, 2023, 26(28): 3513-3519.
[15]	BIAN Lili, LI Xiaoxiao, DU Xueping, DAI Qinfang, WU Lin, SONG Beibei. Risk Stratification of Atherosclerotic Cardiovascular Disease and Lipid Goal Attainment in Hypertensive Patients Registered in Community [J]. Chinese General Practice, 2023, 26(27): 3388-3391.