Date and Time

Session

Faculty

Wednesday, March 10, 2010

12:00 pm – 3:00 pm

Preconference Seminar

Osteoporosis Diagnosis and Risk Assessment

Marjorie Luckey, MD

All postmenopausal women and men age 50 and older should be evaluated clinically for osteoporosis risk. Osteoporosis is preventable and treatable, but because there are no warning signs prior to a fracture, many people are not being diagnosed in time to receive effective therapy. Many factors have been associated with an increased risk of osteoporosis-related fracture.

Preconference Seminar

Clinical Considerations: Therapeutics

Michael McClung, MD

This session provides in-depth information about current FDA-approved pharmacologic options for the prevention and/or treatment of osteoporosis. Topics addressed include: mechanism of action for different drug classes, treatment options, choosing and monitoring therapy, patient counseling and follow up, nonresponders vs. non-compliant patients, and sequential therapy vs. concomitant therapy. Learn how to assess the potential benefits and risks of therapy for the patients in your practice.

Preconference Seminar

Comprehensive Approach to Treatment: Education, Nutrition, Exercise

Jeri Nieves, PhD

Kathy Shipp, PT, MHS, PhD

This seminar will cover current guidelines for prevention and treatment of osteoporosis through proper nutrition and effective exercise, review methods to assess current nutrition and physical activity in an individual at risk of or with osteoporosis, and discuss educational strategies to foster behavior change.

5:30 pm – 7:00 pm

Plenary I

Skeletal Health Across the Lifespan

Laura Bachrach, MD

Beatrice Edwards, MD

James Simon, MD

This didactic session will review skeletal changes over the lifespan.  A session on childhood and adolescence will cover skeletal growth, the impact of nutrition, activity and other contributors to bone accrual.  Changes in skeletal status after peak bone mass attainment will be discussed to include sex hormone depletion, the impact of chronic diseases, lifestyle and efforts to maintain bone density or prevent loss.  Issues of skeletal health in the elderly will include frailty, falls, fracture, polypharmacy, quality of life and interventions to improve skeletal status.  The session will conclude with an interactive panel discussion.

Thursday, March 11, 2009

7:00 am – 8:00 am

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

8:00 am – 10:00 am

Plenary II

Missed Opportunities in Osteoporosis Diagnosis and Treatment

Robert Adler, MD

Robert Gagel, MD

Michael Kleerekoper, MD

Tamara Vokes, MD

This plenary session will begin with an overview of the missed treatment opportunities among various population groups.  It will continue with discussions on men, cancer patients, and people of color. It will describe the challenges of diagnosing and treating patients with postmenopausal osteoporosis and secondary osteoporosis, examine specific subgroups to identify their unique challenges and what should be done in terms of gender, race, and socioeconomic status. Finally, it will review which pharmaceutical agents are approved for each population group.

10:00 am – 11:00 am

Posters and Exhibit Hall Break

11:00 am – 12:30 pm

Plenary III

Use of Imaging in Clinical Diagnosis Lectures and Debate

Douglas Bauer, MD

Harry Genant, MD, PhD

Didier Hans, PhD, PD

Nelson Watts, MD

A series of lectures will address the utility of various technologies to assess bone mass to diagnose osteoporosis.  The appropriate use and limitations of these tools in various clinical settings will be discussed, including obtaining and evaluating sequential measurements.  Finally, a debate on long-term therapy, assessment of potential side effects and monitoring treatment will conclude the session.

12:30 pm -1:30 pm

Exhibit Hall and Poster Tours

1:30 pm – 2:30 pm

History of Bone Mass Measurement

Ken Faulkner, PhD

This discussion of bone mass measurement will include early techniques and how the technology has evolved to the current instrumentation.  The variety of assessment tools will be compared and contrasted, their utility in diagnosing low bone mass or osteoporosis will be discussed and the appropriate use of tools to monitor changes in skeletal status will be reviewed.

Clinical Management: Anabolic Therapy and Biologics

John Bilezikian, MD

This session presents the latest information and research on the use of current FDA-approved medications for osteoporosis prevention and/or treatment.  The focus of this session will be on anabolic agents and biologic therapy. It will explore what a biologic is and how it differs from a medication, mechanism of action of anabolic agents and biologics, clinical issues with PTH and denosumab, when to consider these therapies, and patient management and followup - when & how to monitor.

Improving the Bone Health of Today’s Children

Laura Bachrach, MD

This didactic session will identify children at risk for poor skeletal development and review the nutritional needs for normal bone growth. It will review the calcium and vitamin D requirements among different age groups. It will also explore those conditions that cause concern for peak bone mass in children.

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

2:30 pm – 3:30 pm

Posters and Exhibit Hall Break

3:30 pm – 4:30 pm

Case-based DXA Acquisition in Special Populations

Catherine Gordon, MD

Sparkle Williams, BS

This didactic session will use clinical cases to illustrate the challenges in obtaining bone mass measurements.  Topics addressed will include acquisition in children, patients with physical, developmental or cognitive conditions precluding standard positioning.  Recommendations on alternate imaging or positioning techniques will be discussed.

Clinical Management: Therapy with EAAs/SERMS, ET/HT

Robert Lindsay, MD, PhD

This session presents the latest information and research on the use of current FDA-approved medications for osteoporosis prevention and/or treatment.  The focus of this session will be on estrogen agonist antagonists (SERMs) and appropriate use of estrogen/hormone therapy. It will explore the scientific mechanism of action of EAAs & estrogen, clinical differences & mechanism of action of EAAs & estrogen, clinical issues with EAAs & estrogen,  when to consider these therapies, and patient management and followup - when & how to monitor.

Bariatric Surgery and Bone Health

Brian Sabowitz, MD

This didactic session will explore the different types of bariatric surgery and the skeletal risks of each. Nutritional needs of patients undergoing bariatric surgery will be addressed and proper dietary supplementation will be discussed. Patient monitoring for skeletal effects of bariatric surgery must be done.

4:40 pm – 5:40 pm

Musculoskeletal Imaging

Leon Lenchik, MD

The appropriate use of various imaging techniques and modalities to assess musculoskeletal pain or status will be discussed.  This session is designed to better clarify the utility of specific radiological procedures and offer examples of which imaging modality will best diagnose, injury, disease or conditions.  Clinicians should be able to better communicate with radiologists and order the best test to assess their patients.

Clinical Issues in Long Term Therapy

Nelson Watts, MD

Once medications are prescribed, how long should the treatment continue?  What happens when therapy is discontinued?   This session will discuss issues surrounding long term therapy, including keeping patients motivated, addressing side effects, and monitoring for response to treatment.   It will also explore how long to treat - what does the evidence show, how should the patient be monitored when on different regimens, when should a drug holiday be considered, what to tell patients about adverse actions and effects, and non-compliance vs. non-responder.

Nutrition and Nutraceuticals

Jeri Nieves, PhD

This didactic session will focus on data on a variety of products currently available. It will define nutraceuticals and their potential use in the prevention and/or treatment of osteoporosis; provide best available data on specific products such as OsteoSine, AlgaeCal, and Fosteum, and review nutraceutical controlled studies where available.

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

5:50 pm – 6:50 pm

The Why and How of Precision Assessment

JoAnn Caudill, RT, CDT

This session will explain the necessity and approaches for performing a precision assessment.  It will include discussion regarding the need for clinical monitoring, what information is necessary to make clinical assessments regarding skeletal change and how to obtain the required calculations.  Recommendations on how to perform a precision assessment will be offered and the challenges of obtaining this information will be discussed.

Exercise Prescription in the Real World

Karen Kemmis, PT, DPT, MS

This session will review the current evidence-based physical activity guidelines for the prevention and treatment of osteoporosis.  Through a facilitated interactive discussion, we will address the challenges of an exercise prescription and routine in individual patients with physical limitations and other issues which are common. Discussions about current exercise trends, myths, and road blocks may be included in the session. 

Choosing the Right Therapy for Your Patient

Susan Broy, MD

This session will utilize case based scenarios to identify the most appropriate therapy for prevention or treatment in a variety of osteoporosis patients, including premenopausal and postmenopausal women, men, and patients with secondary osteoporosis.

Evaluating the Medically Complex Patient

Christopher Shuheart, MD

This interactive session common scenarios found in patients with multiple diagnoses will be presented. Participants will be able to prioritize the assessment and treatment of patients with multiple diagnoses and medications. Tips for integrating bone health into complex medical regimens will be discussed.

Case-based Secondary Osteoporosis

Joseph Shaker, MD

This interactive session will address the skeletal implications of commonly occurring secondary causes of osteoporosis. Case-based presentations of common patient scenarios will be discussed. Attendees will be given appropriate methodology for patient workup for common secondary causes of osteoporosis.

Using FRAX® in Practice: For Clinicians

Robert Lindsay, MD, PhD

This session is designed to review the finer points of using FRAX in clinical practice.  It will use cases to discuss appropriate use of FRAX in making clinical decisions.  Topics covered include when not to use FRAX and utility in older patients vs. younger Recent controversies with Canadian recommendations might be presented as well.

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

Friday, March 12, 2010

7:00 am – 8:00 am

The Why and How of Precision Assessment

JoAnn Caudill, RT, CDT

This session will explain the necessity and approaches for performing a precision assessment.  It will include discussion regarding the need for clinical monitoring, what information is necessary to make clinical assessments regarding skeletal change and how to obtain the required calculations.  Recommendations on how to perform a precision assessment will be offered and the challenges of obtaining this information will be discussed.

Exercise Prescription in the Real World

Karen Kemmis, PT, DPT, MS

This session will review the current evidence-based physical activity guidelines for the prevention and treatment of osteoporosis.  Through a facilitated interactive discussion, we will address the challenges of an exercise prescription and routine in individual patients with physical limitations and other issues which are common. Discussions about current exercise trends, myths, and road blocks may be included in the session.

Choosing the Right Therapy for Your Patient

Susan Broy, MD

This session will utilize case based scenarios to identify the most appropriate therapy for prevention or treatment in a variety of osteoporosis patients, including premenopausal and postmenopausal women, men, and patients with secondary osteoporosis.

Evaluating the Medically Complex Patient

Christopher Shuheart, MD

This interactive session common scenarios found in patients with multiple diagnoses will be presented. Participants will be able to prioritize the assessment and treatment of patients with multiple diagnoses and medications. Tips for integrating bone health into complex medical regimens will be discussed.

Case-based Secondary Osteoporosis

Joseph Shaker, MD

This interactive session will address the skeletal implications of commonly occurring secondary causes of osteoporosis. Case-based presentations of common patient scenarios will be discussed. Attendees will be given appropriate methodology for patient workup for common secondary causes of osteoporosis.

Using FRAX® in Practice: For Clinicians

Robert Lindsay, MD, PhD

This session is designed to review the finer points of using FRAX in clinical practice.  It will use cases to discuss appropriate use of FRAX in making clinical decisions.  Topics covered include when not to use FRAX® and utility in older patients vs. younger Recent controversies with Canadian recommendations might be presented as well.

8:00 am – 8:30 am

Exhibit Hall

8:30 am – 10:00 am

Plenary IV

Making Sense of the Guidelines in Everyday Practice

Bess Dawson-Hughes, MD

Edward Puzas, PhD

Laura Tosi, MD

How does the busy clinician make sense of the myriad sets of osteoporosis treatment guidelines that exist today?  These include the NOF Clinician's Guide to Osteoporosis Prevention and Treatment, AOA's Own the Bone, and the Bone and Joint Decade's Roadmap for the Future. Learn how to apply current evidence-based guidance in today's practice environment.

10:00 am – 11:00 am

Posters and Exhibit Hall Break

11:00 am – 12:00 pm

Oral Abstracts Presentations

12:10 pm – 1:10 pm

Obtaining and Incorporating FRAX® Information: For Technologists

Neil Binkley, MD

Diane Krueger, BS, CBDT

This session is designed to help incorporate FRAX® into bone density practices.  The function and use of FRAX® will be discussed along with options to integrate the tool with bone mass acquisition.  This will include identification of relevant patient history, discussion on how DXA manufacturers will integrate into software and discussion of a collaborative approach by clinicians and technologists to implement into clinical practice.

Premenopausal Women

Adi Cohen, MD, MHS

Little guidance exists for the management of osteoporosis in younger premenopausal women. Learn appropriate counseling for the well woman.   Important clinical concerns in premenopausal osteoporosis include bone mass, bone accrual, risk factors for bone loss, clinical outcomes, and management issues. Issues addressed include nutrition and exercise guidance, secondary causes and identifying pts who need additional testing, and differentiating the 'worried well' from the 'unworried unwell'.

Fractures, Fracture Healing and Vertebral Augmentation

Susan Bukata, MD

Fergus McKiernan, MD

This session will explore how osteoporotic bones fracture, how fractures heal and when to consider vertebral augmentation.  Patient assessment for vertebral augmentation will be discussed along with indications for pain management and making appropriate referrals.  Additionally, the effect on fracture healing of current FDA-approved medications, including bisphophonates and PTH, for osteoporosis treatment will be discussed.

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

1:10 pm – 2:10 pm

Exhibit Hall and Poster Tours

2:10 pm – 3:10 pm

Reimbursement and Coding Issues Interactive Session

Kim Fletcher

E. Michael Lewiecki, MD

This session will explore how to code uncomplicated testing and intervention. This includes coding for proper diagnosis, for screening and evaluation, and patient follow up. It will also discuss the resources available for clinicians such as the NOF Reimbursement Guide.

Managing the Frail, Elderly Patient

Neil Binkley, MD

Douglas Kiel, MD

For a number of reasons, the elderly are of particular concern for osteoporosis management and fracture prevention.  Learn how to address issues of frailty, comorbidity and muscle weakness in order to better manage these patients in the office, home and long term care settings.  This session will explore the issues associated with the frail elderly, including interrelationship between low bone mass, vitamin D deficiency, muscle weakness, comorbid conditions, polypharmacy, sensory deficits and fracture risk.  Also, how these patients should be assessed and monitored, drug selection for bedbound elderly, and fall prevention strategies.

Resource Utilization for Patient Education

Susan Randall, RN, MSN, CFNP

This didactic session will identify means to access credible material for patient osteoporosis-related education.  Methods to relay information and educate patients on the comprehensive approach to osteoporosis treatment will also be discussed. It will also explore the importance of patient education in the comprehensive approach to osteoporosis care, identify where to access credible osteoporosis education materials for patients, and provide methods by which to relay osteoporosis information to patients in your practice.

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

3:20 pm 4:20 pm

Posters and Exhibit Hall Break

4:30 pm – 5:30 pm

DXA Pitfalls: Stump the Expert

Harold Rosen, MD

Unusual clinical DXA cases will be presented to an expert panel.  Potential technical errors, diagnoses or anatomical variations relevant to cases will be discussed.  Audience participation is encouraged.

Subtrochanteric Fractures

Susan Bukata, MD

Attendees at this session will better understand the etiology of subtrochanteric fractures. Current research on these fractures and their link to certain drugs will be reviewed. Strategies for patient counseling will be discussed.

Genetics

Douglas Kiel, MD

This session will provide an overview of genes and skeletal development and discuss the increased incidence of osteoporosis due to genetic factors. Prevention strategies for persons at risk will be explored. Guidance for patients and families will be provided and counseling techniques will be discussed.

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

5:40 pm – 6:40 pm

Safe Movement and Fall Prevention

Kathy Shipp, PT, MHS, PhD

This interactive session will generate discussion regarding evaluation tools to assess balance dysfunction and estimate fall risk in an individual.  Strategies to address fall prevention will be reviewed.  A discussion will address important elements necessary to improve successful return to function after a fracture. 

Case-based Compliance and Persistence

Deborah T. Gold, PhD

Stuart Silverman, MD

This interactive session will include a brief discussion of research issues around compliance and persistence with osteoporosis medications.  Then case studies will be presented to demonstrate the real-world challenges associated with all osteoporosis medications. Specifically it will discuss the challenges around compliance and persistence with osteoporosis medications, review differences between intentional and unintentional noncompliance, consider strategies to help patients comply and persist with their medications, and provide ideas on how to identify and help people who initially don't fill prescriptions.

Case-based DXA Quality

Ken Faulkner, PhD

Patient cases will be used to illustrate how poor quality DXA negatively impacts patient care.  Recommendations on how to assess scans or reports for potential errors will be discussed.

Making Appropriate Referrals and Patient Follow Up

Ivy Alexander, PhD, ANP-BC

Can your patients benefit from a multidisciplinary care team approach?  Appropriate and timely referrals to specialty physicians and ancillary care providers can help improve patients’ response to treatment and improve quality of life.  This session will focus on a multispecialty team approach for when to refer for specialty medical evaluation, nutrition counseling, physical therapy, home health care, pain management, etc.

Nutrition and Digestive Issues Related to Osteoporosis

Brian Sabowitz, MD

This session will discuss the various nutrition related causes of osteoporosis and the digestive system diseases with skeletal implications. The nutritional needs of the person at risk will be discussed as well as vitamin D insufficiency and deficiency. Conditions and diseases such as malnutrition, total parenteral nutrition, malabsorption syndromes, celiac disease and Crohn’s disease will be explored.

FRAX® Role Play: For Technologists

Kyla Kent, CBDT

This interactive session is designed to demonstrate methods for technologists to accurately obtain patient information necessary for the FRAX® tool.  Attendees will be instructed on taking medical history, challenges of this process and how to address them will be discussed.

Saturday, March 13, 2010

7:00 am – 8:00 am

Safe Movement and Fall Prevention

Kathy Shipp, PT, MHS, PhD

This interactive session will generate discussion regarding evaluation tools to assess balance dysfunction and estimate fall risk in an individual.  Strategies to address fall prevention will be reviewed.  A discussion will address important elements necessary to improve successful return to function after a fracture. 

Case-based Compliance and Persistence

Deborah T. Gold, PhD

This interactive session will include a brief discussion of research issues around compliance and persistence with osteoporosis medications.  Then case studies will be presented to demonstrate the real-world challenges associated with all osteoporosis medications. Specifically it will discuss the challenges around compliance and persistence with osteoporosis medications, review differences between intentional and unintentional noncompliance, consider strategies to help patients comply and persist with their medications, and provide ideas on how to identify and help people who initially don't fill prescriptions.

Case-based DXA Quality

Ken Faulkner, PhD

Patient cases will be used to illustrate how poor quality DXA negatively impacts patient care.  Recommendations on how to assess scans or reports for potential errors will be discussed.

Making Appropriate Referrals and Patient Follow Up

Ivy Alexander, PhD, ANP-BC

Can your patients benefit from a multidisciplinary care team approach?  Appropriate and timely referrals to specialty physicians and ancillary care providers can help improve patients’ response to treatment and improve quality of life.  This session will focus on a multispecialty team approach for when to refer for specialty medical evaluation, nutrition counseling, physical therapy, home health care, pain management, etc.

Nutrition and Digestive Issues Related to Osteoporosis

Brian Sabowitz, MD

This session will discuss the various nutrition related causes of osteoporosis and the digestive system diseases with skeletal implications. The nutritional needs of the person at risk will be discussed as well as vitamin D insufficiency and deficiency. Conditions and diseases such as malnutrition, total parenteral nutrition, malabsorption syndromes, celiac disease and Crohn’s disease will be explored.

FRAX® Role Play: For Technologists

Kyla Kent, CBDT

Ed Leib, MD

This interactive session is designed to demonstrate methods for technologists to accurately obtain patient information necessary for the FRAX® tool.  Attendees will be instructed on taking medical history, challenges of this process and how to address them will be discussed.

Hands On DXA Workshop

These small interactive workshops are open to technologists and clinicians.  Computers are provided with manufacturer software and cases loaded to allow attendees use the analysis tools.  A clinician and technologist faculty will collaboratively lead a discussion of each case.  Attendees are encouraged to come with questions and concerns regarding DXA acquisition and analysis.  Although these sessions are manufacturer specific, industry representatives will not participate in the sessions.

8:15 am – 9:15 am

Plenary V

Public Policy and DXA Reimbursement

National Action Plan for Bone Health

Roberta Biegel

Andrew Laster, MD

This session will provide an update on the current state of reimbursement for DXA and describe the key components of the National Action Plan for Bone Health. It will explore the effects of cuts in DXA reimbursements on patient access to care. The role of the clinician in the National Action Plan and opportunities for engagement will be addressed.

9:30 am – 10:30 am

On the Horizon: New Therapeutic Mechanisms

Robert Recker, MD

This session will describe the current state of pharmacologic research and new intervention pathways and therapeutic targets. It will address current anti-resorptive and anabolic therapies in the production pipeline.

Assessment of Bone Strength: What do the New Technologies Tell Us?

This didactic session will explore new and emerging technologies designed to assess bone strength or quality.  The technology behind these modalities and what information they generate will be discussed along with their clinical application will be discussed.

10:30 am – 12:00 pm

Plenary VI

Communicating Risk to Patients Panel Discussion

Kyla Kent, CBDT

E. Michael Lewiecki, MD

Denis Lynch, DDS, PhD

This session will discuss the challenges of communicating the risk of therapeutic intervention versus the risk and consequences of osteoporotic fracture to your patients. It will identify methods by which to discuss risk with your patients, discuss the incidence of ONJ with bisphosphonate therapy, both IV and oral administration, review means to treat ONJ and discuss therapeutic outcomes, identify common patient questions presented to technologists during a bone density exam, and discuss what information might be relayed to patients in a clinical setting.