Nonpharmacological interventions for osteoporosis treatment: Systematic review of clinical practice guidelines

Abstract

ObjectivesThe aim of this study was to perform a systematic review of clinical practice guidelines to identify nonpharmacologic recommendations for osteoporosis treatment.MethodsA systematic review of literature following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-statement methodology for clinical practice guidelines was conducted; PROSPERO CRD42019138548. Assessment of selected clinical practice guidelines with the AGREE (Appraisal of Guidelines for Research & Evaluation)-II methodological quality instrument was performed, and those graded over 60 points were selected for recommendations extraction and evidence analysis.ResultsOnly 6 clinical practice guidelines fulfilled criteria, 69 nonpharmacological recommendations were extracted: 13 from American Association of Clinical Endocrinologists and American College of Endocrinology guideline, 16 from Malaysian Osteoporosis Society guideline, 15 from the Ministry of Health in Mexico guideline, 14 from Royal Australian College of General Practitioners guideline, 7 from Sociedad Española de Investigación Ósea y del Metabolismo Mineral guideline, and 7 from National Osteoporosis Guideline Group guideline. Percentage by theme showed that the highest number of recommendations were 12 (17.1%) for vitamin D, 11 (15.7%) for a combination of calcium and vitamin D, and 11 (15.7%) for exercise.ConclusionsThese recommendations address integrating interventions to modify lifestyle, mainly calcium and vitamin D intake, and exercise. Other recommendations include maintaining adequate protein intake, identification and treatment of risk factors for falls, and limiting the consumption of coffee, alcohol and tobacco. Considerations on prescription must be taken.

Cancer Treatment–Induced Bone Loss (CTIBL): State of the Art and Proper Management in Breast Cancer Patients on Endocrine Therapy

“…Smoking habit is associated with an increased risk of osteoporosis, and the risk decreases with the duration of cessation [52,53], while alcohol consumption seems to exert different effects on BMD according to drinking pattern and levels [54]. Coffee consumption was not significantly associated with neither femoral neck nor lumbar spine BMD, and previous reports of negative effects of caffeine should be ascribed to lower calcium intakes rather than direct consequence [55,56].…”

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“…Following a systematic review of Coronado-Zarco et al (2019[ 31 ]), nonpharmacologic treatment can be summarized in 14 points for clinical practice (see Table 2 (Tab. 2) ; References in Table 2: Al-Bashaireh and Alqudah, 2020[ 2 ]; Avenell et al, 2016[ 7 ]; Bischof-Ferrari et al, 2004[ 13 ]; Bougioukli et al, 2019[ 18 ]; Chau et al, 2020[ 23 ]; Compston et al, 2017[ 30 ]; Dobnig, 2011[ 44 ]; Ganz and Latham, 2020[ 52 ]; Gillespie et al, 2012[ 54 ]; Holick, 2007[ 60 ]; Tinetti, 2003[ 122 ]; Vandenbroucke et al,.…”

Evaluation of satisfaction and preference in patients with osteoporosis receiving Denosumab

“…Modifying lifestyle, calcium and vitamin D intake and exercise are the main non-pharmacological treatments of OP. Other non-pharmacological treatments are adequate protein intake, treatment of risk factors for falls, and limiting the consumption of coffee, alcohol and tobacco [6]. Pharmacological treatments of OP are oral bisphosphonates (alendronate, risedronate, ibandronate, etc), hormone replacement therapies, raloxifen, teriparatide, strontium ranelate, intravenous bisphosphonates and denosumab [7].…”