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Dedicated screener leads to more patients being tested, treated for osteoporosis in fracture clinics
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 Joanna E.M. Sale |
A study from researchers at St. Michael’s Hospital in Toronto has determined that the use of a dedicated screener in fracture clinics increases the number of patients who are tested and treated for osteoporosis.
The study, published in Osteoporosis International, found providing bone mineral density (BMD) testing or prescription drug treatment as part of an in-clinic program rather than referring fracture patients elsewhere improves overall outcomes.
The researchers, led by Joanna E.M. Sale, PhD, reviewed osteoporosis screening and management programs involving patients treated for fragility fractures by orthopedic staff in 11 countries — examining randomized trials and clinical programs available to all patients.
“We found that patient outcomes were better with programs that had dedicated personnel to test for and treat the disease,” Sale stated in a St. Michael’s press release. “It makes sense to have someone who can identify patients who might have osteoporosis, educate them, refer them for a [BMD] test, schedule them for the test and write a prescription.”
“Outcomes are also better when the test or treatment takes place within the program, rather than sending the patient elsewhere and potentially losing contact with them,” she added.
Outcome data for the clinical programs and randomized trials was calculated within 6 months of screening in the effort to assemble an equated proportion (EP) across interventions through an intention-to-treat principle. Measured outcomes were the proportion of patients who underwent bone densitometry analysis, the proportion of patients who were initiated on medication for osteoporosis and the proportion of patients taking osteoporosis medication.
The team identified 2,259 citations, with 57 articles comprising 64 intervention groups proving eligible. Across all outcomes, the authors reported, EPs were higher for interventions that included dedicated personnel in the implementation of intervention. Further, EPs were also found higher in those situations where BMD testing and/or treatment were included. Less than 35% of patients were initiated upon osteoporosis medication and less than 45% were taking medication within the 6-month mark of screening for studies demonstrating an EP.
Reference:
- Sale JEM, Beaton D, Posen J, et al. Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients. Osteoporos Int. 2011. doi: 10.1007/s00198-011-1544-y
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