Background/Purpose: Despite increased awareness of the magnitude and consequences of osteoporosis and the availability of recommendations for screening and treatment by multiple organizations, osteoporosis is still under diagnosed and inadequately managed in the United States. Identifying patients at risk, making a timely diagnosis, implementing prevention measures and initiating pharmacologic therapy for appropriate patients can all help to minimize fracture risk. Academic hospitals with resident-led outpatient primary care providers are an area where there may be under-utilization of evidence-based fracture risk assessment tools, such as the Fracture Risk Assessment Tool (FRAX) score.
Methods: House staff of the Internal Medicine department at Beth Israel Medical Center where given an anonymous questionnaire. The goal was to assess the resident’s knowledge of current practice guidelines and recommendations for osteoporosis and the utilization of the FRAX score.
Results: 48 residents of Internal Medicine, levels PGY 1, 2 and 3, filled out the questionnaire. 63% of residents estimated their female patient population was greater than 65 years old and 31% of their male patient population was greater than 70 years old. 77% of residents performed age appropriate DEXA scans on their patients. 58% of residents had knowledge of what the FRAX score was and 48% of resident knew the appropriate use in patient care. 62% used the FRAX score to identify patients who met criteria for the initiation of treatment for osteoporosis. 29% could identify the modifiable risk factors and 31% identified the non modifiable risk factors which calculate the FRAX score. 33% of residents said they would use the FRAX score on woman less than 65 years old. 79% of residents wanted to receive more information on the FRAX score and its appropriate applications.
Conclusion: Appropriate identification and prevention are imperative to reducing the risk of osteoporosis and osteoporosis-related fractures in individuals. Our study concluded that Internal Medicine residents at one academic medical center are following the current guidelines for screening for osteoporosis with DEXA scans, however, the use of the FRAX score for the identification of patients at high risk for fracture requiring the initiation of treatment for osteoporosis, is highly underutilized. There was also a discrepancy between the resident’s knowledge of the FRAX score and its application in clinical practice. Further training and education regarding osteoporosis screening and the use of the FRAX score in a resident led outpatient primary care setting will be beneficial to resident providers and their patients.
Disclosure:
J. Brodsky,
None;
M. Greenfield,
None;
E. Patton,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/osteoporosis-screening-and-fracture-risk-assessment-tool-usage-among-house-staff/