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03-02-2010 | Bone health | Article

BMD result recall poor in patients at risk for osteoporosis

Abstract

Free abstract

MedWire News: Patients have poor recall of bone mineral density (BMD) results 3 years after screening, reveals research reported in the journal Osteoporosis International.

Elaine Kingwell (University of British Columbia, Vancouver, Canada) and colleagues examined whether giving patients dual-energy X-ray absorptiometry (DXA) results directly or via their physician affected their recall of the result 3 years later.

“Direct-to-participant feedback may prompt individuals to learn more about osteoporosis and its associated risks and treatments by engaging them directly in the management of their health, and provides a ‘backup’ to ensure that patients receive their test results if family physicians do not pass the results on,” the team explains.

The researchers followed-up 2678 women and men aged 40–60 years participating in a Canadian study who had undergone hip and spine screening.

Women were overall more likely than men to correctly recall any DXA result (54% vs 42%), and correctly remember a diagnosis of osteoporosis (34.2% vs 24.9%).

Receiving results directly rather than through their physician only improved recall of borderline or normal BMD results, but not a diagnosis of osteoporosis.

Older men were better at recalling an osteoporosis diagnosis than younger men, as were men, but not women, who had sustained a vertebral fracture.

Women were more likely to recall a diagnosis of osteopenia if they had been given the result directly, had a family history of osteoporosis, good health, or a recommendation for osteoporotic treatment. But no factor predicted correct recall of osteoporosis diagnosis in women.

The researchers say that their findings suggest an optimistic bias in the recollection of BMD results that places the patient at lower risk than average, while those with a diagnosis of osteopenia or osteoporosis were likely to “minimize” the seriousness of their results.

“Although both an optimistic bias and minimization of test results can diminish motivation to adopt preventive behavior, they have been shown to have positive adaptive psychological value, with reduction of stress, better adjustment and active coping,” Kingwell et al note.

While acknowledging that diagnostic criteria and osteoporosis awareness have increased in recent years, the team concludes that it “seems reasonable to assume that the findings from this study are a reliable indication of the potential for communication and awareness of DXA test results following BMD screening in a mid-aged population of Canadians today.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Lynda Williams

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