Background/Purpose: US Preventive Task Force (USPSTF) recommends screening for osteoporosis in women ≥ 65 years of age with dual-energy X-ray absorptiometry (DEXA) scan. There was inconsistent pattern of ordering DEXA scans for screening of osteoporosis at our internal medicine clinic (IMC) at Conemaugh Memorial Medical Center. The main aim of this study was to improve the compliance with screening for osteoporosis with DEXA scan at our IMC as per recommendations by USPSTF.

Methods:

• This is a quasi-experimental study with a pre and post intervention observational periods.
• Patients’ medical charts from IMC at Conemaugh Memorial Medical Center were reviewed before an intervention period during which residents and clinic staff were educated regarding the importance of screening for osteoporosis and role of DEXA scans.
• Resident education sessions emphasizing the importance of screening for osteoporosis with DEXA scan were conducted twice a month for a period of 3 months. The need of DEXA screening in women ≥ 65 years, the correct interpretation of DEXA scans and the medication options for women diagnosed with osteoporosis or those with osteopenia who qualify for treatment were emphasized.
• Post intervention data was collected by reviewing patients’ medical charts. Pre and post intervention data was compared to see if the above interventions resulted in improvement in compliance with screening for osteoporosis.

Results:

• Data from our pre intervention phase showed that 72 women met criteria for osteoporosis screening. Based on our analysis, 32% (23/72) women appropriately received osteoporosis screening with DEXA scan.
• Post intervention data revealed that 58% (134/229) of patients that qualified for screening received DEXA scans.
• This observed 26% increase was statistically significant (P = .0002, z-test for significant difference between two independent proportions).

Conclusion: DEXA scans have been identified as the most sensitive screening test for osteoporosis. Based on the results of DEXA scans, patients can be started on medications like bisphosphonates which have been associated with a decreased incidence of fragility fractures. Our post intervention data has demonstrated a significant improvement in the osteoporosis screening practices of the IMC residents. The intervention measures used by us were simple, proved to be effective, and can be readily implemented in other primary care settings.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/improving-compliance-with-screening-for-osteoporosis-in-elderly-women/