Houston: At the Forefront of Diagnosing and Treating Osteoporosis

Guest blog post by Dr. Laila Tabatabai, Dr. Robert F Gagel, and Dr. Nahid Rianon.

One of the most persistent health challenges we confront in our medical practices is osteoporosis, a disease that makes a person’s bones weak and more likely to break. Osteoporosis related bone fractures are responsible for more hospitalizations than heart attacks, strokes and breast cancer combined, yet more than 80% of people with the disease are never diagnosed or treated. It’s not due to lack of knowledge or available care. The reality is that most diagnoses occur after a bone fracture has already happened. One in two women and up to one in four men over the age of 50 will break a bone in their lifetime due to osteoporosis. Approximately 10 million Americans have osteoporosis and another 44 million have low bone density, placing them at increased risk for fractures.

Fortunately, when it comes to improving diagnosis and treatment options to address the growing health crisis of osteoporosis, Houston is leading the charge. Ours is the first U.S. city to launch the Healthy Bones/Healthy Cities initiative, a program to educate and support healthcare practitioners across a variety of fields to help them successfully diagnose and treat osteoporosis. 

The National Osteoporosis Foundation (NOF) has selected Houston to launch this important program -- one that will not only improve patient outcomes here, but create best practices for physicians all over the country to incorporate into their practices. NOF recognized Houston’s high quality of existing medical care and our city’s existing focus on healthy aging. From the Mayor’s Pledge for Successful Aging, to the UTHealth Consortium on Aging, and the Huffington Center on Aging, Houston is an ideal launching point for a program that will eventually take place in other cities across the country.

In partnership with Houston Methodist, UTHealth, and MD Anderson, the Houston Healthy Bones/Healthy Cities initiative will raise awareness and bring about better care for osteoporosis patients. Fifteen healthcare providers -- from family practice, internal medicine, obstetrics/gynecology (OB/GYN), and advanced practice providers -- will be trained in the program to help screen, diagnose and treat for osteoporosis. Each provider has committed to training 10 colleagues, so there will be 150 new osteoporosis experts in Houston with the ability to reach thousands of patients from the very start.

These physicians will be part of a national movement to help prevent and treat osteoporosis, empower osteoporosis patients to make and sustain changes that improve their health and reduce the risk of fracture and death. As part of the initiative, we will collect data on patient care improvements and ensure access to high quality care for women and men with osteoporosis. We must change the status quo around this disease; we must evaluate and treat the 80% of individuals who suffer from an osteoporotic fractures but have never been evaluated or treated.

A variety of strategies are already in place for proactively dealing with osteoporosis. The call-to-action for Healthy Bones/Healthy Cities is to get these strategies into the mainstream of local healthcare. Getting enough calcium-rich foods and vitamin D every day, doing regular weight-bearing and muscle-strengthening exercises, not smoking and not drinking too much alcohol, talking to your healthcare provider about when you should have a bone density test, and taking an osteoporosis medication if needed can help prevent debilitating, often deadly, fractures. A wide range of effective medications are available for treating osteoporosis. Osteoporosis-specific diet and exercise approaches are readily available. Again, the missing link has been making sure that healthcare professionals identify patients with and at risk for osteoporosis and discuss prevention and treatment options. Healthy Bones/Healthy Cities is designed to accomplish just that. And in doing so, the health of our city will be improved, and we’ll be paving the way to create healthier communities across the country. 

About the authors:
Dr. Nahid Rianon is associate professor of the geriatric medicine division at the McGovern Medical School at UTHealth. She also runs the Geriatric Osteoporosis clinic at the UT Physicians Center for Healthy Aging; her main research interest is osteoporosis due to age-related bone loss in older adults with chronic co-morbidities and fracture prevention. 

Dr. Robert F Gagel, M.D. is a Professor of Medicine at the M.D. Anderson Cancer Center and the Founding Director of the Rolanette and Berdon Lawrence Bone Disease Program of Texas, a collaborative program of MD Anderson Cancer Center, Baylor College of Medicine and University of Texas Health Science Center at Houston focused on bone health.

Dr. Laila Tabatabai is an endocrinologist at Houston Methodist Hospital and she serves as the Director of the Houston Methodist Fracture Liaison Service. She is also the Program Director of the Houston Methodist Endocrinology Fellowship Program.  Dr. Tabatabai is considered a key opinion leader in the field of fracture management and anabolic (bone-building) osteoporosis medications.