Educational workshop improves osteoporosis medical practices
MedWire News: Physicians who attend a 1-hour, interactive workshop on the prevention of fragility fractures are more likely to refer women for osteoporosis screening and initiate treatment than those who do not attend, study findings indicate.
However, no difference was observed in screening and treatment initiation among men, report Lyne Lalonde (Centre de santé et de services sociaux de Laval, Canada) and colleagues.
To assess the impact of a fragility fracture-prevention workshop on osteoporosis-related medical practices, Lalonde and team compared the rates of bone mineral density (BMD) testing and osteoporosis treatment initiation among elderly patients (aged 70 years or older) of physicians that did (exposed), and did not attend the workshop (unexposed).
In total, 25 exposed physicians (1124 patients) and 209 unexposed physicians (9663 patients) observed at least one patient eligible for inclusion in the study.
The researchers report that women followed-up by exposed physicians were twice as likely to receive BMD testing (8.5% vs 4.2%) and initiate treatment with bone specific drugs (BSDs, 4.8% vs 2.4%) such as bisphosphonates, raloxifen, and calcitonin than women followed-up by unexposed physicians.
In contrast, rates of BMD testing (0.8% vs 1.0%) and BSD treatments (0.6% vs 0.3%) were low in men, regardless of whether the physician had attended the workshop or not.
In high-risk patients, namely those with long-term glucocorticoid therapy or with a previous osteoporotic fracture, higher rates of treatment initiation with BSDs were observed in women followed-up by exposed physicians compared with unexposed physicians (12.0% vs 1.9%).
In contrast, high-risk men were more likely to receive calcium/vitamin D if they were treated by exposed physicians, compared with unexposed physicians (5.3% vs 0.8%).
"Considering that clinical practice guidelines recommend that all men and women aged 65 years or older undergo BMD testing and that treatment be initiated in patients at high risk for osteoporosis, the results of this study confirm the very large gap between osteoporosis guideline recommendations and current primary care practice, particularly for men," conclude Lalonde et al in the journal Osteoporosis International.
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By Laura Dean