Osteoporosis screening and treatment guidelines

Schnatz, Peter F.; Marakovits, Kimberly A.; Dubois, Melissa; O’Sullivan, David

doi:10.1097/gme.0b013e318215101a

Cited by 33 publications

(24 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 In a survey of women referred for DXA screening at one center, over 40 % of screened women under the age of 65 years did not meet criteria for screening. 11 However, to our knowledge, the degree of DXA overuse across an entire screening population has not been reported.…”

Section: Introductionmentioning

confidence: 81%

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

et al. 2015

View full text Add to dashboard Cite

BACKGROUND:The United States Preventive Services Task Force (USPSTF) recommends screening for osteoporosis with dual-energy x-ray absorptiometry (DXA) for women aged ≥ 65 years and younger women with increased risk. BChoosing Wisely^initiatives advise avoiding DXA screening in women younger than 65 years without osteoporosis risk factors. OBJECTIVE: We aimed to determine the extent to which DXA screening is used in accordance with USPSTF recommendations within a regional health system. DESIGN: This was a retrospective longitudinal cohort study within 13 primary care clinics in the Sacramento, CA region. PATIENTS: The study included 50,995 women aged 40-85 years without prior osteoporosis screening, diagnosis, or treatment attending primary care visits from 2006 to 2012, observed for a mean of 4.4 years. MAIN MEASURES: We examined incidence of DXA screening. Covariates included age, race/ethnicity, and osteoporosis risk factors (body mass index<20, glucocorticoid use, secondary osteoporosis, prior high-risk facture, rheumatoid arthritis, alcohol abuse, and current smoking). KEY RESULTS: Among previously unscreened women for whom the USPSTF recommends screening, 7-year cumulative incidence of DXA screening was 58.8 % among women aged 60-64 years with ≥ 1 risk factor (95 % CI: 51.9-65.8 %), 57.8 % for women aged 65-74 years (95 % CI: 55.6-60.0 %), and 42.7 % for women aged ≥ 75 years (95 % CI: 38.7-46.7 %). Among women for whom the USPSTF does not recommend screening, 7-year cumulative incidence was 45.5 % among women aged 50-59 years (95 % CI 44.1-46.9 %) and 58.6 % among women aged 60-64 years without risk factors (95 % CI 55.9-61.4 %). CONCLUSIONS: DXA screening was underused in women at increased fracture risk, including women aged ≥ 65 years. Meanwhile, DXA screening was common among women at low fracture risk, such as younger women without osteoporosis risk factors. Interventions may be needed to augment the value of population screening for osteoporosis.

show abstract

Section: Introductionmentioning

confidence: 81%

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…BMD of different national groups have differences, which have been recognized by level of development and national medical standards. [18][19][20]. At the same time, reports about the prevalence of osteoporosis were very different, and this difference may also be related to the race groups in the population.…”

Section: Discussionmentioning

confidence: 94%

Measurement of Bone Mineral Density from Different Race of Elderly Population in Mianyang, China

Penga¹,

Huang²,

Song³

et al. 2017

J Gerontol Geriatr Res

View full text Add to dashboard Cite

show abstract

“…Prior research has shown that, among 944 healthy women in Ontario referred for a baseline DXA test at midlife, more than 90% had normal bone density. 12 Similarly, in a US cohort of 615 women aged 49 years or more who received a baseline DXA test, Schnatz and colleagues 13 found that 40% did not meet the North American Menopause Society criteria for testing. 2 In a recent study involving 4957 women aged 67 years or more with normal bone mineral density or osteopenia, osteoporosis was detected in less than 10% during rescreening intervals of about 15 years.…”

Section: Discussionmentioning

confidence: 99%

Impact of a change in physician reimbursement on bone mineral density testing in Ontario, Canada: a population-based study

et al. 2014

View full text Add to dashboard Cite

CMAJ OPEN, 2(2) E45 Research CMAJ OPENA bone mineral density test using dual-energy x-ray absorptiometry (DXA) evaluates the quantity of bone mineral and is used to make a diagnosis of reduced bone mass or osteoporosis and to provide information that contributes to an assessment of fracture risk. Together with other risk factors for fracture, information gained from a bone mineral density test can guide clinicians and patients in understanding the risk of an osteoporosis-related fracture; it can also inform decisions aimed at mitigating these risks (e.g., initiation of bisphosphonates treatment). 1,2Clinical practice guidelines in Canada currently recommend bone mineral density testing in at-risk populations, namely all men and women aged 65 years or more and those who have had a fragility fracture after age 40 years.2,3 The recommended management model is based on assessment of fracture risk, which is derived in part from measured bone mineral density and appears on bone mineral density reports for most patients over age 50. For patients assessed as high risk, guidelines indicate that there is good evidence to support pharmacotherapy; for those assessed as low risk, guidelines state that patients are unlikely to benefit from pharmacotherapy and should be reassessed in 5 years.3 Thus, bone mineral density testing, as well as knowledge of clinical risk factors that can modify the assessment of fracture risk, are important components of prevention efforts to reduce (secondary) fracture risk. 1,3 In the province of Ontario, Canada, a sharp increase in the rate of bone mineral density testing among women aged 40-44 years, for whom fracture risk is typically low, was observed Background: On Apr. 1, 2008, a revision was made to the fee schedule for bone mineral density testing with dual-energy x-ray absorptiometry (DXA) in the province of Ontario, Canada, reducing the frequency of repeat screening in individuals at low risk of osteoporosis. We evaluated whether the change in physician reimbursement successfully promoted appropriate bone mineral density testing, with reduced use among women at low risk and increased use among women and men at higher risk of osteoporosis-related fracture.

show abstract

Osteoporosis screening and treatment guidelines

Abstract: In this prospective study, depression-detected by a validated three-item questionnaire-was able to predict those women more likely to develop CHD.

Cited by 33 publications

References 11 publications

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

Underuse and Overuse of Osteoporosis Screening in a Regional Health System: a Retrospective Cohort Study

Measurement of Bone Mineral Density from Different Race of Elderly Population in Mianyang, China

Impact of a change in physician reimbursement on bone mineral density testing in Ontario, Canada: a population-based study

Contact Info

Product

Resources

About