Correlation between patient recall of bone densitometry results and subsequent treatment adherence.
Treatment of osteoporosis is often inadequate. One reason can be insufficient patient education following diagnostic bone densitometry (DXA). Therefore, we studied how patients are informed and treated following their first DXA. Individuals who had DXA at a rural hospital in Wisconsin were surveyed with a questionnaire regarding their post-test education and prescribed treatment. Their DXA results and the specialty of their clinician were also recorded. Eighty percent of the 1,014 participants were informed of their results. Of the 341 participants who had normal bone mineral density (BMD), 63% reported correct results, while only 31% of the 309 who had osteopenia and 50% of the 364 who had osteoporosis reported correct results. Accuracy in reporting was not affected by the patients' age or the specialty of their clinicians. Following DXA, 339 patients (33%) were started on medications; 86% of those remained on some prescribed therapy for osteoporosis, but 140 (41%) did not continue the initial medication. Reasons for discontinuation included side effects (48%) and cost (26%). Patients with low BMD who correctly reported their results were more likely to have received a medication and to continue to take it ( p <0.0001). Calcium supplements were recommended to 65% of those not taking calcium prior to DXA. Internists were more likely than family practitioners to recommend calcium, and their patients reported better medication adherence, as did those with osteoporosis compared with osteopenia. We conclude that, while most participants are informed of the results of their DXAs, the retained information may not be accurate. Correct understanding of DXA results may lead to higher treatment rates and better adherence to treatment among patients with low BMD.
Pickney
Cynthia S
CS
University of Wisconsin, Madison, Wisconsin, USA.
Arnason
Jon A
JA
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D002118:Calcium / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D014922:Wisconsin
D002118:Calcium
Am J Med. 2003 Aug 15;115(3):209-16
12947959
Clin Ther. 2004 Feb;26(2):245-56
15038947
Rheumatology (Oxford). 2002 Sep;41(9):1073-4
12209047
Osteoporos Int. 2001;12(7):559-64
11527053
Lancet. 2002 Jun 1;359(9321):1929-36
12057569
Endocr Pract. 2000 Sep-Oct;6(5):351-6
11141584
Osteoporos Int. 2002;13(6):493-500
12107664
Osteoporos Int. 1999;9 Suppl 2:S2-8
10525719
Arch Intern Med. 1996 Jul 22;156(14):1521-5
8687260
World Health Organ Tech Rep Ser. 1994;843:1-129
7941614
Pharmacotherapy. 2003 Feb;23(2):190-8
12587808
Am J Med. 2000 Sep;109(4):326-8
10996585
Lancet. 2002 Jun 8;359(9322):2018-26
12076571
Arthritis Rheum. 2002 Dec 15;47(6):651-4
12522840
Osteoporos Int. 2001;12(5):337-42
11444079
Mayo Clin Proc. 2002 Apr;77(4):334-8
11936928
Pharmacol Ther. 2002 Jan;93(1):37-49
11916540
J Rheumatol. 2000 Jun;27(6):1496-500
10852277
Osteoporos Int. 2003 Oct;14(10):808-13
14523610
CMAJ. 2001 Mar 20;164(6):777-81
11276543
JAMA. 2001 Dec 12;286(22):2815-22
11735756