James Deardorff
speaker
224 appearances
2 recordings
1 series
first heard Feb 2022
last heard Oct 2022
James Deardorff’s voice in public audio — every appearance, attributed to the second.
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Yeah, I like when he struggles
Yeah, so I completed my geriatrics fellowship last year.
And I think as we go through fellowship, you get a lot of teaching about osteoporosis since it's so common in older adults.
And I was really excited just to learn how to manage these patients because in the patients in geriatrics clinic that we see, fractures just can be so devastating and result in loss of independence.
And so many older adults with diagnosis of osteoporosis have never received any therapy for it.
And I think what I realized, especially during COVID, is that there's just so many barriers and hesitations to starting medications as clinicians were maybe hesitant to start treatments because we're dealing with patients with multiple comorbidities, polypharmacy, frailty.
I know a lot of my patients, there were concerns about ability to take the medication without supervision since they weren't having as much caregiver support during COVID.
or they had difficulty coming into the clinic for an infusion.
They hadn't seen their dentist in a while and were maybe about to get some dental extractions.
And with all those barriers, it just made me wonder, one question, how much would some of these patients benefit?
And really, the more important question is how quickly they would benefit from starting these medications.
And Say had
done a lot of these time-to-benefit types papers with colorectal cancer screening, mammography, and statin use.
And so this felt like a natural extension to those papers.
Yeah.
So if you look at clinical guidelines on management of osteoporosis based on specific criteria with your high risk for fractures, and those vary a little bit by guideline to guideline, but really bisphosphamates are first-line therapy just because we have so much experience with them.
And they really have been shown in several clinical trials to have reductions in
vertebral fractures, non-vertebral fractures, and hip fractures.
So they really are considered first-line therapy for postmenopausal women with osteoporosis.
Yeah, I think, Alex, you hit on the head the two major things that we worry about right away.
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