QUALITY TOOL BOX OSTEOPOROSIS GENERAL & MEDICAL REHABILITATION COUNCIL [GMRC]

Osteoporosis QTB – People & Process GMRC Chair: Michael Stubblefield, MD Performance Metrics Committee Chair: Elizabeth Sandel, MD CHAIR-ELECT & LEAD: K. R. PODURI, MD SUBJECT MATTER EXPERTS: GOPI KASTURI, MD LESLIE MORIS, MD AAPM&R Clinical Practice Guidelines Committee Chair: Richard Zorowitz, MD AAPM&R Evidence Committee, Chair: Thiru Annaswamy, MD PMC Liaison TO GMRC: DEEPTHI SAXENA, MD

CLINICAL PRACTICE GUIDELINES [CPG] Management of Osteoporosis in men AHRQ National Guideline Clearing House Screening for osteoporosis in the adult U.S. population: American College of Preventive Medicine, ACPM) Position statement on preventive practice. Am J Preventive Medicine 2009 Apr;36[4]:

CPG Osteoporosis: Prevention and treatment. Ann Arbor (MI): University of Michigan Health System; 2011 Dec. 16 p. University of Michigan Health System (UMHS). Screening for osteoporosis: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine 2011 Mar 1:154(5):

1.CORE CONSTRUCTS - Symptoms Pain and disability (A, B) A.OSWESTRY DISABILITY INDEX < = 5 minutes Free. No training PRO. 10 sections with 6 items each. ICF Domains - Body Structure, Body Function, Activity, Participation, Environment.

CORE CONSTRUCTS - Symptoms B. PAIN ROLAND-MORRIS DISABILITY QUESTIONNAIRE < = 5/ 10/ 30 min (based on no. of items used, 11, 18 or 24 min.) Free. No training PRO ICF Domain - Body Function

2.CORE CONSTRUCTS - Mobility EXERCISE (4) (5) © 10 METER WALK TEST < 5 min Free No training PBA ICF Domain - Activity

3.CORE CONSTRUCTS – Balance (Falls) A.Tinetti (Prevention and screening tool) 10 to 15 minutes Free No training PRO. ICF Domains – Activity and Participation B.Four Step Square Test (FFST) < 5 minutes Free No training PBA. ICF Domains – Activity

CORE CONSTRUCTS – Balance (Falls) C.BALANCE RIVERMEAD MOBILITY INDEX < 5 min Free No training PRO. 15 items ICF Domain - Activity

CORE CONSTRUCTS – Fracture Prevention D.Fracture Risk (F) FRAX – Though BMD or T score are needed, the system generates a score with interpretation without these. BMI can be used per tool online. – Reference PATO study. E.Diet/ Alcohol/ Smoking

4.CORE CONSTRUCTS - Participation – QOL Participation/Social roles (6) (G) A.LONDON HANDICAP SCALE < 5 min, free, no training. PRO. 6-point scale ICF Domain –Participation

CORE CONSTRUCTS - Participation – QOL B.Quality of Life WHO QOL BREF 10 to 15 min. Free No training PRO. 26 Items Domains - Activity, Participation and Environment.

Quality METRICS AAPM&R - PQRS Measures 40 and Osteoporosis: Management Following Fracture of Hip, Spine or Distal Radius for Men and Women Aged 50 Years and Older 41.Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older

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