Using the Frax Score

We all want strong bones. We have to take calcium. We have to exercise. But is there more too it once menopause starts? The ovarian production of estrogen provides a strong drive for that calcium to stay into bones in a greater density, and inevitably women will have a dramatically increased bone loss at menopause. Thin bones are not as healthy as thicker bones, in most cases. But will that translate into an actual fracture? And if not, it doesn't need medical treatment. This is what the WHO and researchers have tried to convince us with their Frax score . And it's a tool I've been using to discuss bone health with patients for over a year now, and it's really a sophisticated form of the prediction models that WHO encouraged us to use for several years. But remember, even if you score really well on this exam, there are factors the quiz doesn't include. Not only that but in some research studies of alendronate if they tried to look at who benefited from medication based on Frax and unfortunately the prediction model did not hold up. I prefer: individualize the care. Watch your scores over time, take things one year at a time, look at blood tests, urine markers, your posture, find out your VFA (vertebral fracture analysis), get as many facts as possible, especially if you are going to avoid medication. And now in 2014 there has been an emphasis on getting all health care sectors to help in evaluating these scores, and overall factors that contribute to bone health.The pharmacist can improve bone health, and possibly even help patients from ever losing enough bone to become osteoporotic according to a presentation at the American Pharmacists Association (APhA) 2014 Annual Meeting and Exposition in Orlando, Florida by helping women know their risks by calling up their Frax score at the time of a trip to the pharmacy. For many women this may mean medication, but for many it may not. 


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