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Improving Osteoporosis Screening among Elderly Women

Bruce K Muma, MD1, Jennifer Lafata, PhD2, Deneil M Kolk, MPH/MSW2, and Ed Peterson, PhD3. (1) Admin/ Internal Medicine, Henry Ford Health System, One Ford Place, Suite, 3A, Detroit, MI 48202, (2) Center for Health Services Research, Henry Ford Health System, One Ford Place, Suite 3A, Detroit, MI 48202, 313-874-7057, dkolk1@hfhs.org, (3) Biostatistics, Henry Ford Health System, One Ford Place, Detroit, MI 48202

The US Preventive Services Task Force recommends that women age 65 years or older be screened routinely for osteoporosis. Current estimates show only 20% of this population has done so. We report preliminary findings of a randomized prospective study designed to evaluate strategies to enhance detection of osteoporosis in this high risk population. We identified women aged 65-89 that received their primary care from a large multidisciplinary medical group in southeast Michigan. The 15 participating clinics were stratified by size and Bone Mineral Densitometry (BMD) equipment availability and randomized to one of 3 types of osteoporosis disease management strategies: (1) usual care; (2) mailed patient letters; and (3) mailed patient letters plus physician prompts. Women who had a BMD test, a diagnosis for osteoporosis, or a prescription drug claim for an osteoporosis-specific therapy were excluded. 10,565 eligible women were included in the study: 3,110 in strategy (1); 3,368 in strategy (2); and 4,087 in strategy (3). BMD testing rates were evaluated using generalized estimating equation approaches. Preliminary results indicate a BMD screening rate of 2% in group 1, 2% in group 2, and 9% in group 3. Differences between group 1 and 2 were not significant (p=.67). Group 3 strategy lead to significant improvements in BMD testing rates compared to both groups 1 & 2 (p<.001). Results did not change with adjustments for clinic, race or both. The use of mailed patient reminders in combination with physician prompts can lead to significant increases in osteoporosis screening.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

Keywords: Health Promotion, Women's Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

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The 132nd Annual Meeting (November 6-10, 2004) of APHA