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    PART 1 : Appraisal of Current Clinical Practice
  1. Which imaging modality do you use to diagnose osteoporosis in your facility? *

  2. How many patients of severe osteoporosis with T score ≤ - 2.5 do you see in a month at your facility? *

  3. What is the common age group of patients who present with severe osteoporosis with T score ≤ - 2.5 at your facility? *

  4. As per your experience which gender is most commonly affected by severe osteoporosis? *

  5. Do the majority of patients of osteoporosis directly come to you or referred by other specialty? *

  6. Which are the main symptoms with which patient of osteoporosis come to you for treatment? (Tick all that applies) *

  7. What are the most common findings on imaging in osteoporotic patients in your practice? *

  8. Which is most common type of osteoporosis in your practice? *

    9. PART 2 : Use of teriparatide in the management of severe osteoporosis

    Express your opinion about following statements

  9. What are the factors on which you decide to prescribe teriparatide in your practice? *

  10. What are your treatment goals when you prescribe teriparatide in osteoporotic fractures? (Tick all that applies) *

  11. What is the treatment duration with teriparatide in the management of osteoporosis with fragility fracture? *

  12. How long does callus take to become evident in imaging after teriparatide administration in osteoporotic fractures? *

  13. Do you give teriparatide and denosumab combination to get optimum results in the management of osteoporosis? *

  14. Do you give teriparatide and bisphosphonate combination to get optimum results in the management of osteoporosis? *

  15. Have you come across any case of malignancy with teriparatide usage? *

  16. What are the common adverse drug reactions which you come across with teriparatide? Please mention common ADRs

  17. Do you repeat the course of teriparatide therapy after discontinuation in same patient if he/she comes again with features of severe osteoporosis? *

  18. What are the barriers to use teriparatide in the management of osteoporosis? Check all that apply *

  19. Do you use teriparatide in the management of non-osteoporotic fractures? *

  20. Are you aware that US FDA has removed the osteosarcoma boxed warning in 2020 and teriparatide can be used for more than 2 years during a patient’s lifetime if a patient remains at or has returned to having a high risk for fracture? *

  21. Have you observed any difference in outcome after teriparatide treatment between males and females? *

    22. PART 3 : Effectiveness of teriparatide in osteoporotic and non-osteoporotic fractures

    Express your opinion about following statements

  22. Teriparatide accelerates osteoporotic fracture healing *

  23. Upper limb osteoporotic fractures respond better to teriparatide *

  24. Lower limb osteoporotic fractures respond better to teriparatide *

  25. Teriparatide has role in the management of non-union of osteoporotic fracture *

  26. Teriparatide has role in the management of delayed union of osteoporotic fracture *

  27. Teriparatide has role in reduction of pain in osteoporotic fracture *

  28. Teriparatide has role in the management of stress fracture *

  29. Teriparatide has role in the management of traumatic fracture *

  30. Do you prefer to use teriparatide in the management of ……..? *
    31. A) Vertebral fractures, please mention preferred treatment if Teriparatide is not used
    B) Non- vertebral fractures, please mention preferred treatment if Teriparatide is not used
  31. Teriparatide improves weight bearing and reduces pain in non-osteoporotic fractures *

  32. Teriparatide being an anabolic agent improves bone quality in patients *

  33. Maintenance treatment with bisphosphonates can help to maintain improved bone quality achieved with teriparatide and prevent subsequent fractures *

  34. Estimation of bone markers (P1NP and β-CTX) during teriparatide treatment can give better assessment of teriparatide effect on bone *

  35. Assessment of bone formation marker P1NP can improve treatment compliance with teriparatide as patients themselves can see the improvement due to rise in P1NP levels *

  36. Teriparatide is safer anti-osteoporotic anabolic agent compared to other available anti-osteoporotic agents *