title: [Evidence based comparative analysis for managing osteoporosis in a primary health care setting].
abstract: OBJECTIVE
  To find out how physicians are managing osteoporosis in a primary care setting.
  
  
  METHODS
  Cross-sectional study.
  
  
  BACKGROUND
  Primary care setting with a target population of 276,000 inhabitants, grouped into 9 basic health areas, Spain.
  
  
  METHODS
  Women older than 45 years old on treatments for osteoporosis.
  
  
  METHODS
  Standardised questionnaire self-filled in by women and compared with clinical records.
  
  
  METHODS
  Suitability of the indication of diagnostic tests, proportion of treatments supported by diagnostic tests and according to evidence.
  
  
  RESULTS
  The mean age of the sample was 65.3 (9.6) years. Of the women included, 73.2% (n=243) had an indication for densitometry and only 60.2% (n=200) of them had this performed. The results of the densitometries were: 14% (n=28) normal, 31% (n=62) osteopenia and 55% (n=110) osteoporosis. Based on risk factors, in those women with densitometry indication, 39.5% (n=96) did not have it performed. In those women with no risk factors to justify the indication of densitometry (n=89), 59.6% (n=53) did have it performed. The two-year follow densitometry was not carried out on 78.7% (n=261) of women. Statistically significant differences were observed in the percentages of adequacy of the indications of densitometry and in the percentages of adequacy of the treatments in the different medical specialities analyzed (P < .05). Of the women who had densitometry, 42.4% (n=81) were inadequately treated.
  
  
  CONCLUSIONS
  The indication of densitometry is clearly improvable and there is a high variability in its adequacy in all the medical specialities studied. To a great extent, the indication of treatments for osteoporosis is not based on densitometry and is against the recommendations of the evidence based studies recently published.
authors.affiliation: Servicio de Urgencias Generales, Hospital de Cruces, Baracaldo, Vizcaya, España. eunatea@telefonica.net
authors.forename: Eunate
authors.initials: E
authors.lastname: Arana-Arri
authors.forename: Iñaki
authors.initials: I
authors.lastname: Gutiérrez-Ibarluzea
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Gutiérrez Ibarzabal
authors.forename: Pedro
authors.initials: P
authors.lastname: Ortueta Chamorro
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Giménez Robredo
authors.forename: Angel María
authors.initials: AM
authors.lastname: Sánchez Mata
authors.forename: Jose
authors.initials: J
authors.lastname: Asua Batarrita
authors.forename: Elena
authors.initials: E
authors.lastname: Fernández Díaz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003720:Densitometry; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000188:drug therapy; D011320:Primary Health Care; D011795:Surveys and Questionnaires