[Management of osteoporosis in short-term geriatric units].
OBJECTIVE
To identify the recommendations in Canadian and American clinical practice guidelines for the management of osteoporosis that are applicable to vulnerable, older patients in short-term geriatric units (STGU).


METHODS
Modified Delphi approach according to the RAND/UCLA method.


METHODS
A panel of experts from various regions of Quebec.


METHODS
The panel consisted of 6 physicians, 5 pharmacists, and 3 nutritionists recognized by their peers for their expertise in STGU.


METHODS
Eleven recommendations from the North American guidelines were submitted to a panel of experts who were asked to identify those most appropriate for the management of osteoporosis in STGU. Each expert's level of agreement with the recommendations and the experts' general level of agreement were used to determine the relevance of the recommendations.


RESULTS
The experts reached a consensus on each of the 11 recommendations. Seven recommendations were deemed appropriate for the management of osteoporosis in vulnerable, older patients in STGU. Bone mineral density measurement as a parameter for follow-up was the only recommendation deemed inappropriate in this context. The experts remained uncertain about 3 recommendations: systematic screening for osteoporosis by bone mineral density measurement; systematic screening or evaluation of the risk factors for fractures; and pharmacologic prevention in vulnerable, older patients with an increased risk of fracture.


CONCLUSIONS
Some of the recommendations issued in the North American recommendations appear to be less appropriate for managing osteoporosis in vulnerable, older patients in STGU. The recommendations retained in this study could be used to standardize interventions for these patients and to determine the extent to which current practice follows the recommendations.
Champoux
Nathalie
N
Centre de recherche, Institut universitaire de gériatrie de Montréal, 4565 chemin Queen Mary, Montréal, QC H3W 1W5.
Lafleur
Martine
M
Bertrand
Benoît
B
Gilbert
Suzanne
S
Latour
Judith
J
Kergoat
Marie Jeanne
MJ
D000328:Adult; D015519:Bone Density; D003697:Delphi Technique; D005260:Female; D005500:Follow-Up Studies; D005853:Geriatrics; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011792:Quebec; D014481:United States
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