The LURN Urinary Urgency and Lifestyle Wearable Tracker (ULTra) study: Design and feasibility.

Osteoporosisis a chronic asymptomatic metabolic bone disease associated with low bone density, poor bone quality, and reduced bone strength which manifests clinically as a fracture. Fractures related to osteoporosis are frequent. Although one study reported a consistent decline in fracture rate from 2007 to 2013, trends from 2014 to 2017 indicate that fracture rates are no longer declining and for some fracture types, rates are rising [, ]. Khan et al. in a recent study report a rising trend in hip fractures in male veterans from 2006to 2019, a finding that underscores the growing concern regarding fracture risk in aging populations and highlights the need for greater attention to osteoporosis at both clinical and public health levels []. Denosumab is one of the several medications available that reduce the likelihood of osteoporotic fractures. Denosumab is a humanized monoclonal antibody initially approved by the FDA in 2010 for the treatment of both post-menopausal and male osteoporosis []. It is given as a 60-mg subcutaneous injection every 6 months in a health care setting. It is very effective in reducing fractures at all sites; however, numerous published studies indicate that abrupt discontinuation of denosumab leads to a rapid reversal of the bone mineral density (BMD) gains seen with the medication [, ]. Further, delaying denosumab doses beyond 7 months results in transient increase in bone turnover known as the rebound phenomenon []. Both scenarios increase the risk of multiple vertebral fractures known as (RAVF). Osteoporotic fractures already impose substantial clinical, functional, and economic burden []. Within this context, rebound-associated vertebral fractures can double or triple the per-patient cost of post-fracture management and substantially elevate risks of functional decline and recurrent fractures.