MedWire News: Family physicians are failing to target osteoporosis screening to the patients at greatest risk for the condition, highlight US researchers in a study published in the Journal of General Internal Medicine.
“We found that individuals with several osteoporosis risk factors, such as advanced age, oral steroid use >1 month, loss of height, and history of low-trauma fracture were either not more likely to receive osteoporosis screening recommendations or not more likely to undergo screening, when adjusting for other osteoporosis risk factors,” report Smita Nayak (University of Pittsburgh, Pennsylvania, USA) and co-workers.
The team explains that the National Osteoporosis Foundation and other organizations recommend osteoporosis screening for women and men from around the age of 65 and 70 years, respectively, and for younger individuals with other risk factors.
To determine which patients are recommended to and who undergo screening, the team asked 1830 adults aged 60 years or older living in western Pennsylvania to complete a survey.
Overall, 1268 adults completed the survey, of who 92.9% were White, 58.8% were female, and 88.2% said they were in good health.
Of these participants, 47.6% said their physician had recommended osteoporosis screening and 62.6% of participants reported having undergone screening.
Of note, older participants were less likely to have been recommended to have screening than younger participants, with an odds ratio (OR) of 0.87 per 5-year increase in age.
Analysis showed that screening was most often recommended to women, White patients, those with a family history for osteoporosis, and participants reporting using arms to get up from a chair.
However, participants with risk factors for osteoporosis, such as history of oral steroid use for more than 1 month, loss of height of 2.54 cm or more, or a history of low-trauma fracture were no more likely to be recommended to undergo screening than other individuals.
Similarly, participants were significantly more likely to undergo screening if they were female, had a family history of osteoporosis or a personal history of low-trauma fracture, and if they had a greater weight but a height loss of 2.54 cm or more.
Likelihood of osteoporosis screening was not associated with increasing age, prolonged oral steroid use, White race, alcohol consumption, or smoking.
“Our study points to the need for physicians to better assess older adults’ osteoporosis risk, recommend screening to individuals at risk, and follow-up with screening for at-risk individuals,” Nayak et al say.
“Improving screening rates in individuals at greatest risk for osteoporosis is an important step towards improving health outcomes.”
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