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8. Knowledge and Needs of Resident Physicians Regarding Osteoporosis: A Nationwide Survey of Residents

Author

Crandall, Carolyn J, Chen, Lucia Y, Rodriguez, Tyler D, Elashoff, David, Faubion, Stephanie S, Kling, Juliana M, Shifren, Jan, Skinner, Lisa, and Bauer, Douglas C

Subjects
Osteoporosis, Aging, Musculoskeletal, FRACTURE, MEDICAL EDUCATION, OSTEOPOROSIS, RESIDENCY
Abstract

Large-scale studies have not addressed the knowledge level of US resident physicians regarding osteoporosis management. We gauged the knowledge level of family medicine, internal medicine, and obstetrics and gynecology resident physicians regarding osteoporosis management. In 2019, we sent an anonymous survey via e-mail to all program directors of Accreditation Council for Graduate Medical Education-accredited residency programs in family medicine, internal medicine, and obstetrics and gynecology for distribution to resident physicians. Knowledge items assessed osteoporosis screening, diagnosis, and treatment. We received responses from 182 family medicine, 275 internal medicine, and 122 obstetrics and gynecology programs. Of 582 resident physician respondents, 31% were family medicine residents, 47% were internal medicine residents, and 21% were obstetrics and gynecology residents. Although 77% of respondents correctly selected the T-score threshold for the diagnosis of osteoporosis among persons aged 50 years and older (-2.5), only 20% of respondents correctly identified minimal-trauma hip fracture as being diagnostic of osteoporosis. One-third of respondents correctly identified which medications were demonstrated in clinical trials to decrease hip fracture risk. Fifteen percent of respondents correctly identified that denosumab and alendronate are associated with osteonecrosis of the jaw; and 40% of respondents correctly identified that decline in bone density is more rapid after discontinuation of denosumab than after discontinuation of bisphosphonates. Less than half of resident physicians knew that bisphosphonate-associated atypical femoral fractures are duration-dependent. One-quarter of respondents felt not at all prepared to manage osteoporosis. In this nationwide survey of resident physicians, knowledge regarding osteoporosis diagnosis and treatment was poor, with a striking lack of knowledge regarding the two most serious adverse effects of osteoporosis pharmacotherapy (osteonecrosis of the jaw and atypical femoral fractures). The undertreatment of osteoporosis is unlikely to improve without increased education of resident physicians. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Published
2021

14. The Quality of Life after Endometrial Cancer Study: Baseline Characteristics and Patient-Reported Outcomes.

Author

Warring, Simrit, Yost, Kathleen J., Cheville, Andrea L., Dowdy, Sean C., Faubion, Stephanie S., Kumar, Amanika, Lemens, Maureen A., Van Oort, Chelsie C., Fought, Angela J., Mc Gree, Michaela E., Mariani, Andrea, and Glaser, Gretchen

Subjects
PHYSICAL mobility, SEXUAL excitement, PATIENT reported outcome measures, GYNECOLOGIC oncology, ENDOMETRIAL cancer
Abstract

Endometrial cancer (EC) patients make up the second largest group of female cancer survivors. Patient-reported outcomes (PROs) including quality of life (QOL) and sexual function and satisfaction (SF and S) are critical facets of survivorship. This prospective, longitudinal study assesses associations between baseline characteristics and PROs after treatment. Herein, we report the baseline clinical characteristics and PROs prior to treatment initiation. Outcomes post-treatment over time will be reported separately. Patients with planned surgery for EC were prospectively enrolled in 2019–2021 and administered the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 30 (QLQ-C30), EORTC QLQ EC Module (EN24), Patient-Reported Outcomes Measurement Information System (PROMIS), and the Mayo Clinic lower extremity lymphedema (LEL) questionnaire. This study enrolled 198 patients with a mean (SD) age of 63.6 (9.8) years and body mass index of 35.5 (8.3) kg/m2. No significant differences in the PROs for the QOL were seen when compared to the reference means (SD) except for the lower interest in sexual activity (31.9 (9.8) vs. 47.5 (SE0.70)) and lower fatigue (21.3 (19.8) vs. 31.7 (25.9)). Increased obesity was associated with an increased likelihood of LEL (p < 0.01) and multiple QOL scales, including poorer global health status (p < 0.01) and physical functioning (p < 0.01). Prior to treatment initiation for EC, the patients had a similar QOL compared to that of the general population. The patients with increasing obesity, a known risk factor for EC, had worse overall global health status and physical functioning. A better understanding of these QOL measures is imperative for earlier identification and intervention of patients at risk of chronic impairments from EC treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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21. A New Era in Menopause Management?

Author

Faubion, Stephanie S. and Shufelt, Chrisandra L.

Subjects
*MEDICAL personnel, *SUPER Bowl advertisements, *SUBSTANCE P receptors, *SLEEP interruptions, *SLEEP quality, *PREMATURE menopause, *MENSTRUATION disorders
Abstract

The editorial discusses the increasing mainstream attention to menopause management, particularly in relation to vasomotor symptoms (VMS) like hot flashes and night sweats. It highlights the historical context of hormone therapy usage rates and the safety concerns raised by the Women's Health Initiative trials. The article introduces fezolinetant, a novel nonhormonal drug approved for VMS treatment, and discusses the potential of elinzanetant, a dual NK1 and NK3 receptor antagonist, in reducing VMS frequency and improving quality of life. The text emphasizes the need for individualized menopause management and the importance of advancing care with nonhormonal treatment options. [Extracted from the article]

Published
2024
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24. Fractional CO2 laser therapy for genitourinary syndrome of menopause for breast cancer survivors

Author

Quick, Allison M., Zvinovski, Filadelfiya, Hudson, Catherine, Hundley, Andrew, Evans, Cynthia, Suresh, Anupama, Stephens, Julie A., Arthur, Elizabeth, Ramaswamy, Bhuvaneswari, Reinbolt, Raquel E., Noonan, Anne M., VanDeusen, Jeffrey Bryan, Wesolowski, Robert, Stover, Daniel G., Williams, Nicole Olivia, Sardesai, Sagar D., Smith, Karen L., Faubion, Stephanie S., Loprinzi, Charles L., and Lustberg, Maryam B.

Published
2020
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35. Cognitive Health Update in Midlife Women.

Author

Saadedine, Mariam, Faubion, Stephanie S., Kling, Juliana M., and Kapoor, Ekta

Subjects
*DEMENTIA risk factors, *ALZHEIMER'S disease risk factors, *HYPERTENSION in pregnancy, *PERIMENOPAUSE, *LIFE change events, *HORMONE therapy, *RISK assessment, *COGNITIVE testing, *PREMATURE menopause, *DISEASE complications, *MIDDLE age
Abstract

The article focuses on cognitive health in midlife women, exploring associations between hypertensive disorders of pregnancy (HDP), cardiometabolic measures in early menopause, and vasomotor symptoms with cognition and brain health. Topics include the impact of HDP on cognitive decline, the correlation between cardiometabolic measures and cognitive function in postmenopausal women, and the association between menopausal vasomotor symptoms and white matter hyperintensities in the brain.

Published
2024
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41. Vasomotor Symptoms During Menopause: A Practical Guide on Current Treatments and Future Perspectives

Author

Khan,Saira J, Kapoor,Ekta, Faubion,Stephanie S, Kling,Juliana M, Khan,Saira J, Kapoor,Ekta, Faubion,Stephanie S, and Kling,Juliana M

Abstract

Saira J Khan,1 Ekta Kapoor,2– 4 Stephanie S Faubion,2,5 Juliana M Kling2,6 1Department of Internal Medicine, Mayo Clinic, Phoenix, AZ, USA; 2Mayo Clinic Women’s Health, Rochester, MN, USA; 3Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA; 4Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA; 5Division of General Internal Medicine, Mayo Clinic, Jacksonville, FL, USA; 6Division of Women’s Health Internal Medicine, Mayo Clinic, Scottsdale, AZ, USACorrespondence: Juliana M Kling, Division of Women’s Health Internal Medicine, Mayo Clinic, 13737 N 92 23 nd St, Scottsdale, AZ, 85260, USA, Tel +1-480-614-6001, Fax +1-480-614-6021, Email Kling.Juliana@mayo.eduAbstract: Vasomotor symptoms affect as many as 80% of midlife women, but only about one in four women receive treatment due to many factors. Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms, and current professional guidelines conclude that the benefits of treatment typically outweigh the risks for healthy, symptomatic women under age 60 years and those within 10 years from their final menstrual period. For women with medical comorbidities, an individualized approach to treatment is recommended. For women who cannot use or choose not to use menopausal hormone therapy, there are many evidence-based non-hormonal options available including pharmacologic therapies. This review aims to summarize treatment options for bothersome vasomotor symptoms to guide clinicians caring for midlife women.Keywords: menopause, vasomotor symptoms, menopausal hormone therapy, non-hormonal treatments

Published
2023

42. In Reply

Author

Faubion, Stephanie S., Larkin, Lisa C., Simon, James A., and Kingsberg, Sheryl A.

Published
2018
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47. In Reply

Author

Faubion, Stephanie S., Larkin, Lisa C., Simon, James A., and Kingsberg, Sheryl A.

Published
2019
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