Use of decision rules for osteoporosis prevention and treatment: implications for nurse practitioners.

PURPOSE

To describe the current literature regarding the benefits of bone mineral density (BMD) screening and to discuss clinical decision rules for BMD screening.

DATA SOURCES

Extensive review of the scientific literature regarding osteoporosis, BMD screening, and current clinical decision rules.

CONCLUSIONS

Osteoporosis is a disease characterized by deterioration of bone and increased susceptibility to fractures, crippling, and disfigurement. BMD testing is the best predictor for osteoporosis and associated fractures; however, routine global BMD testing is cost-prohibitive. A need exists for a selective and practical clinical decision rule for referral for testing.

IMPLICATIONS FOR PRACTICE

Several effective clinical decision rules are presented, and their uses and applications are described. The osteoporosis self-assessment tool is recommended by the authors because of its predictive power and ease of use.