Musculoskeletal Conditions

Osteoporosis Management in Women Who had a Fracture

Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine, and wrist, although any bone can be affected. Osteoporosis is a major public health threat for an estimated 44 million Americans or 55% of the people 50 years of age or older. In the U.S. today, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at risk for osteoporosis. Eighty percent of those affected by osteoporosis are women.

Osteoporosis is responsible for more than 1.5 million fractures annually. A balanced diet rich in calcium and vitamin D, weight-bearing exercise, a healthy lifestyle with no smoking or excessive alcohol intake, and bone density testing and medication (when appropriate) completed together can optimize bone health and help prevent osteoporosis.

This HEDIS measure estimates the percentage of women 67 years of age and older who suffered a fracture, and who had either a bone mineral density test or prescription for a drug to treat or prevent osteoporosis in the six months after the date of fracture during the intake period.

Use of Imaging Studies for Low Back Pain

In the United States, at least 80 percent of adults have at least one episode of low back pain during their lifetimes. Low back pain and degenerative joint disease account for almost 5% of all adult physician visits, and the direct medical costs related to low back pain exceed $25 billion annually. Fortunately, in as many as 90 percent of patients, acute low back pain resolves within six weeks regardless of treatment methods.

The approach to evaluation of low back pain varies considerably among physicians, current evidence suggests that many of the tests performed are unnecessary and overuse of imaging studies ranged from 20% among primary care physicians to 70% among orthopedists.

This HEDIS measure assesses whether imaging studies such as X-rays, MRIs, CT scans, are overused in evaluating patients with acute back pain. A higher score indicates the appropriate treatment of low back pain i.e. an imaging study did not occur when it was not necessary.

Disease Modifying Anti-Rheumatic Drug Therapy

Rheumatoid arthritis is a chronic autoimmune disorder often characterized by progressive joint destruction and multisystem involvement. It affects approximately 2.5 million Americans, and women disproportionately. There is no cure; consequently, the goal of treatment is to slow the progression of disease and thereby delay or prevent joint destruction, relieve pain and maintain functional capacity.

This measure assesses whether patients diagnosed with rheumatoid arthritis (RA) have been prescribed a disease modifying anti-rheumatic drug (DMARD). DMARDs modify the disease course of rheumatoid arthritis through reduction of the progression of bony erosions, lessening of inflammation and long-term structural damage. The utilization of DMARDs is also expected to provide improvement in functional status.

CCHRI Senior Manager
Cathie Markow, PBGH
cmarkow@pbgh.org

Reporting Principles

Guidelines for Use of Data

About the Reports

Clinical Measure Descriptions