Effective strategies to identify postmenopausal women at risk for osteoporosis.

The early identification of postmenopausal women at risk of fracture, followed by effective therapeutic intervention, can substantially improve patient outcomes. Bone mineral density measurements and comprehensive risk assessment are essential components in deciding when to intervene with osteoporosis pharmacologic treatment. Simple, easy-to-administer risk assessment tools are available to assist the physician in identifying patients in need of further evaluation or treatment and aid in patient counseling. Furthermore, effective pharmacologic treatments are available that have demonstrated reductions in the risk of vertebral and nonvertebral fractures. Some therapies, such as selective estrogen receptor modulators and bisphosphonates, are able to act early in the course of treatment to reduce this risk of vertebral and nonvertebral fractures. The tools to reduce the underrecognition and undertreatment of osteoporosis are readily available. Primary care physicians are in a unique position to use these tools as part of a more proactive approach to fracture prevention in postmenopausal patients.