Presenter(s): Ken Schmader, MD; Cathleen Colon-Emeric, MD; Anthony J. Caprio, MD Disclosure(s): Cathleen Colon-Emeric, MD received a consultant fee and research support from Novartis.Product(s) made by this company related to this topic: Zoledronate acid. Kenneth Schmader, MD received a grant and a consultant fee from Merck & Co., Inc. Product(s) made by this company related to this topic: Zoster Vaccine. Anthony J. Caprio, MD has no relevant financial relationships to disclose. Session Description: In this session presenters describe current evidence regarding the appropriate use of bisphosphonates for osteoporosis, zoster vaccine to prevent shingles and its complications, and feeding tubes in end stage dementia. Three clinical experts highlight the issues that are pertinent to the long term care setting through clinical case examples. Learning Objectives:
Describe the clinical and economic factors that should be considered when deciding whether to use the zoster vaccine in nursing home patients
Describe the factors that influence the risk reduction for fracture when using bisphophontes, especially age and life expectancy
Describe current research data that should inform the use of feeding tubes for long term care patients
References: 1. Oxman MN. Levin MJ. Johnson GR. Schmader KE. Straus SE.Gelb LD et al. Shingles Prevention Study Group. A vaccine to prevent herpeszoster and postherpetic neuralgia in older adults. NewEngland Journal of Medicine. 2005;352(22):2271-84. 2. Carey TS, Hanson LC, Garrett JM, Lewis CL, Phifer N, CoxCE, Jackman A. Expectations and outcomes of gastric feeding tubes. Am J Med2006;119:527.e11-6. 3. Mitchell SL. A 93-Year-Old Man With Advanced Dementia andEating Problems. JAMA 2007;298:2527-2536. 4. Gloth FM 3rd. Simonson W. Osteoporosis is underdiagnosedin skilled nursing facilities: a large-scale heel BMD screening study. [JournalArticle. Research Support, Non-U.S. Gov't] Journal of the American MedicalDirectors Association. 9(3):190-3, 2008 Mar. 5. Colon-EmericCS. Lyles KW. House P. Levine DA. Schenck AP. Allison J. Gorospe J. Fermazin M.Oliver K. Curtis JR. Weissman N. Xie A. Saag KG. Randomized trial to improvefracture prevention in nursing home residents. American Journal of Medicine. 120(10):886-92, 2007 Oct.