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Adherence of academic geriatric practitioners to osteoporosis screening guidelines

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Abstract

Objectives

To examine the bone mineral density (BMD) testing habits of geriatricians and geriatric fellows at the University of Connecticut fellowship training program to evaluate their adherence screening guidelines.

Design

Retrospective chart review.

Setting

University based academic geriatric practice in Farmington, CT.

Participants

Chart review of two hundred female patients over age 65 under care of seven faculty geriatricians and eight geriatric fellows in training.

Measurements

Data collected included BMD testing status, patient’s osteoporosis risk factors and functional status.

Results

Physicians ordered BMD tests in 151 (76%) patients; 128 (64%) had a bone mineral density test within three years. A personal history of fracture was the only osteoporosis risk factor that correlated to higher rates of osteoporosis testing. Physicians were more likely to order BMD screening in younger patients (92% in 65–74 vs. 74% in ages 85+, P=.031), patients independent in activities of daily living (72% vs. 32, P=.002), and patients without dementia (70% vs.37%, p=.007). BMD testing results found 82% with osteopenia or osteoporosis.

Conclusions

A geriatric group that is highly attuned to bone health demonstrated more optimal adherence to OP testing guidelines for all “at-risk” older women and better than reported previously. Functional status more strongly predicted BMD testing than osteoporosis risk factors. This study suggests that with improved physician education and familiarity with the disease, high rates of BMD testing for earlier identification of geriatric patients at risk for osteoporosis are achievable.

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Acknowledgment

This study was supported by an Independent Educational Grant from the Alliance for Better Bone Health.

Conflict of interest statement

Financial disclosures:

D. McNally: There are no conflicts of interest for this author.

Anne M. Kenny: There are no conflicts of interest for this author.

Jo-Anne Smith is on the Speakers Bureau of Merck Pharmaceuticals and Proctor and Gamble (P&G) Pharmaceuticals. She is a consultant for P&G. She has had no significant financial holdings in these companies in the past 12 months; there are no conflicts of interest for this author.

Author Contributions:

D. McNally performed all the chart data abstraction and initial manuscript preparation.

A. Kenny had a role in study design, analysis and interpretation of the data and manuscript preparation.

Jo-Anne Smith had a role in the initial concept and design of the study, acquisition of the IRB, analysis and interpretation of the data and preparation of the manuscript.

Sponsor’s Role:

The Alliance for Better Bone Health provided a small educational grant to assist in statistical analysis and costs of manuscript preparation. They had no role in the design, methods, subject recruitment, data collection or analysis or the preparation of the paper.

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Authors and Affiliations

  1. University of Connecticut School of Medicine (DNM), Farmington, CT, 06030-5456, USA

    D. N. McNally, A. M. Kenny & J.-A. Smith

  2. Musculoskeletal Institute, MC-5456, University of Connecticut Health Center (JAS, AMK), Farmington, CT, 06030-5456, USA

    D. N. McNally, A. M. Kenny & J.-A. Smith

Authors
  1. D. N. McNally
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  2. A. M. Kenny
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  3. J.-A. Smith
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Corresponding author

Correspondence to J.-A. Smith.

Additional information

This study was supported by an Independent Educational Grant from the Alliance for Better Bone Health.

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McNally, D.N., Kenny, A.M. & Smith, JA. Adherence of academic geriatric practitioners to osteoporosis screening guidelines. Osteoporos Int 18, 177–183 (2007). https://doi.org/10.1007/s00198-006-0215-x

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