Impact of a primary care physician workshop on osteoporosis medical practices.
CONCLUSIONS
Attendance at a fragility-fractures-prevention workshop by primary care physicians was associated with higher rates of osteoporosis screening and treatment initiation in elderly female patients and higher rates of treatment initiation in high-risk male and female patients. However, osteoporosis management remained sub-optimal, particularly in men.


BACKGROUND
Rates of osteoporosis-related medical practices of primary care physicians exposed to a fragility-fractures-prevention workshop were compared with those of unexposed physicians.


METHODS
In a cluster cohort study, 26 physicians exposed to a workshop were matched with 260 unexposed physicians by sex and year of graduation. For each physician, rates of bone mineral density (BMD) testing and osteoporosis treatment initiation among his/her elderly patients 1 year following the workshop were computed. Rates were compared using multilevel logistic regression models controlling for potential patient- and physician-level confounders.


RESULTS
Twenty-five exposed physicians (1,124 patients) and 209 unexposed physicians (9,663 patients) followed at least one eligible patient. In women, followed by exposed physicians, higher rates of BMD testing [8.5% versus 4.2%, adjusted OR (aOR) = 2.81, 95% CI 1.60-4.94] and treatment initiation with bone-specific drugs (BSDs; 4.8% vs. 2.4%, aOR = 1.95, 1.06-3.60) were observed. In men, no differences were detected. In patients on long-term glucocorticoid therapy or with a previous osteoporotic fracture, higher rates of treatment initiation with BSDs were observed in women (12.0% vs. 1.9%, aOR = 7.38, 1.55-35.26), and men were more likely to initiate calcium/vitamin D (5.3% vs. 0.8%, aOR = 7.14, 1.16-44.06).


CONCLUSIONS
Attendance at a primary care physician workshop was associated with higher rates of osteoporosis medical practices for elderly women and high-risk men and women. However, osteoporosis detection and treatment remained sub-optimal, particularly in men.
Laliberté
M-C
MC
Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada.
Perreault
S
S
Dragomir
A
A
Goudreau
J
J
Rodrigues
I
I
Blais
L
L
Damestoy
N
N
Corbeil
D
D
Lalonde
L
L
D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000517:prevention & control; D017063:Outcome Assessment, Health Care / Q000379:methods; D058007:Physicians, Primary Care / Q000193:education* / Q000592:standards; D011320:Primary Health Care / Q000592:standards; D011364:Professional Practice / Q000592:standards / Q000706:statistics & numerical data; D011792:Quebec
D050071:Bone Density Conservation Agents