Increased Osteoporosis Screening Rates Associated with the Provision of a Preventive Health Examination

Abstract

Objectives:We determined the frequencies of (1) female patients aged 65 years and older having bone density measurement performed and (2) prescription therapy use among osteoporotic women.Methods: We completed a retrospective chart audit to assess our adherence to Physician Quality Reporting Initiative guidelines. Women aged 65 to 75 with an office visit between June 1 to November 30, 2007, were divided into 3 subgroups: those who had a recent preventive general medical examination (GME), those who received one in the last 10 years, and those who had not. We determined osteoporosis screening rates for all 3 groups. The first group then underwent electronic medical record review to obtain patient demographics, determine bone mineral density results, and review if those with osteoporosis were receiving prescription treatment.Results: Ninety-six percent of 305 female patients seen for a GME during the study period had completed bone mineral density testing. This was a screening rate significantly greater than that for patients with an earlier GME and those who never had one in our offices (70% and 50%, respectively). Seventyseven percent of recent GME patients had abnormal T scores. Low weight and body mass index were significantly associated with osteoporotic T scores. Seventy-four percent of patients whose latest T scores were less than ؊2.5 were receiving prescription therapy.Conclusions: Female patients who completed a recent GME had extraordinarily high rates of screening for osteoporosis. We believe this demonstrates the importance of a dedicated preventive health examination as well as the increased significance that physicians and patients currently place on this be- Primary care physicians have the opportunity to screen women for osteoporosis and intervene as indicated.

The Effectiveness of Osteoporosis Screening and Treatment in the Midwest

“…In patients who have not sustained a previous fragility fracture, adding osteoporosis screening questions to a preventative health examination with general physical examination can significantly increase (96%) the rate of osteoporosis screening. 22 …”

“…The number was lower than expected when compared to previous studies that have shown up to 58% taking appropriate medication. 22 However, there have been reports of treatment rates of osteoporosis as low as 2% after hip fractures. 23 …”

A Typical Day in the Family Medicine Office

“…Grover et al 8 found high rates of screening and treatment for osteoporosis among older women who received a general preventive examination compared with those who did not. More evidence supporting the recommendation of a routine physical is needed to encourage completion of needed prevention items.…”

“…Looks like a typical day in the family medicine office! Although most of the authors are from university family medicine departments and residency programs, [1][2][3][4][5][6][7][8][9][10] we also welcome contributions with implications for primary care from others outside the field.…”

Guest Family Physician Commentaries

“…This study makes a good argument to have a registry or an electronic medical record that allows us to audit our work. At the Mayo Clinic, Grover et al 3 had such a registry; however, we audit our osteoporosis patients' charts using electronic billing reports that are easily queried and with the paper record; this shows it can be done without an electronic registry.…”