title: Family physicians' personal and practice characteristics that are associated with improved utilization of bone mineral density testing and osteoporosis medication prescribing.
abstract: Family physicians' personal and practice characteristics may influence how osteoporosis is managed. Thus, we evaluated the impact of family physicians' personal and practice characteristics on the appropriate use of bone mineral density testing and osteoporosis therapy. The physician questionnaire assessed 13 personal and practice characteristics of the physicians. The patient questionnaire was used to collect data to ascertain how family physicians managed osteoporosis. A total of 225 family physicians from 7 provinces across Canada completed both the physician and patient questionnaires. The family physicians evaluated a total of 5601 patients. The generalized estimating equations technique was utilized to model the associations between family physicians' personal and practice characteristics and appropriate use of bone mineral density testing and osteoporosis therapy. Odds ratios (OR) and corresponding 95% confidence intervals (CI) are reported. Findings indicated that female family physicians have higher odds of administering appropriate bone density testing compared to male family physicians (OR: 1.28; 95% CI: 1.05, 1.55), and that physicians who have hospital privileges (OR: 0.77; 95% CI: 0.62, 0.97) and who graduated more recently from medical school (OR: 0.87; 95% CI: 0.77, 0.99) have lower odds of administering appropriate bone mineral density tests. Physicians who use electronic health records have higher odds of administering appropriate therapy (OR: 1.30; 95% CI: 1.06, 1.59) as compared to physicians who do not use them. Several family physicians' personal and practice characteristics are associated with appropriate utilization of bone mineral density testing and therapy. The education of both clinicians and policy makers regarding these new insights may translate to enhanced individual practices and an improved overall health care system to optimize the environment for managing osteoporosis.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Ioannidis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Papaioannou
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
authors.forename: Anthony
authors.initials: A
authors.lastname: Hodsman
authors.forename: Brent
authors.initials: B
authors.lastname: Kvern
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Walsh
authors.forename: Famida
authors.initials: F
authors.lastname: Jiwa
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Adachi
mesh_terms: D000368:Aged; D015519:Bone Density / Q000502:physiology*; D002170:Canada; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D010821:Physicians, Family; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires