腎と骨代謝 Vol.31 No.2(4)


特集名 骨粗鬆症リエゾンサービスの現状と未来
題名 骨粗鬆症リエゾンサービスと骨折一次予防
発刊年月 2018年 03月
著者 中藤 真一 あさひ総合病院整形外科
【 要旨 】 脆弱性骨折一次予防には,地域・社会での骨粗鬆症リエゾンサービスの提供が重要である.具体的には,骨粗鬆症の予防,教育,啓発,検査機会の提供,患者早期発見などがある.なかでも患者早期発見には検診が有用であるが,低い実施率,受診率,骨密度での評価,対象者,実施間隔などに問題がある.こうしたなか,多職種の骨粗鬆症マネージャーがそれぞれの専門性を生かしてさまざまな視点から骨折高リスク者を抽出,介入することが必要である.骨粗鬆症マネージャーの活躍の場として病院,診療所,地域・社会がある.病院,診療所では骨粗鬆症マネージャーによるグループ形成が進んでいるが,地域・社会ではこの取り組みが遅れている.しかし骨折の一次予防では,この地域・社会でのリエゾンサービスの普及が重要である.今後は地域・社会でもマネージャーが連携しproject teamとして機能していくことが望まれる.
Theme Perspective of Osteoporosis Liaison Service in Japan
Title Primary fracture prevention through the Osteoporosis Liaison Service
Author Shinichi Nakatoh Department of Orthopaedic Surgery, Asahi General Hospital
[ Summary ] It is difficult to prevent primary fragility fractures because the subjects have not yet experienced a fracture. The offers of the community Osteoporosis Liaison Service are important for the primary prevention of fragility fractures. The prevention, education, enlightenment, and osteoporosis examinations are included in this service. It is necessary to deliver the prevention services and osteoporosis education according to the age of the subjects. Hence, for young individuals, it is effective to include in their school education that having a high peak bone mass is important; for the middle-aged population, it is necessary to include education on the maintenance of bone quantity and the impact on risk factors, such as smokingand excessive alcohol consumption. Furthermore, early detection of osteoporosis is important, with an osteoporosis check-up being one of the few opportunities for assessing the bone mineral density in elderly women. However, there are some problems with osteoporosis checkups in Japan. Various types of professional medical staff participate in the Osteoporosis Liaison Service as osteoporosis managers. It is desired that the managers will cooperate and function as an osteoporosis project team in the community.
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