title: Appraising osteoporosis care gaps.
abstract: To evaluate physician response to dual-energy X-ray absorptiometry (DXA) report within the Geisinger Medical Center's Mobile DXA Program and treatment adherence at 1 year. Between 10/01/2004 and 3/30/2005, 1381 DXA scans were performed in our Mobile DXA Program. Within this cohort, we identified 366 high-risk, drug-naive patients and report the percentage of patients placed on prescription drug therapy within 90 days of DXA result. Additionally, we identified 191 patients with Z-score of -1.0 or worse and report whether laboratory tests were ordered within 90 days of DXA results in this group. Finally, we determined treatment adherence at 1 year. 269 patients (74%) were offered prescription therapy within 3 months of DXA results. Of those, 210 (57%) were still adherent to drug therapy at 1 year. The main reason for discontinuation of treatment was an adverse drug side effect. Additionally, in 50% cases, physicians ordered 1 or more laboratory tests to evaluate low Z-score. Within our Mobile DXA Program, 74% of high-risk, drug-naïve patients were treated. Interestingly, in 50% cases, when a low Z-score was reported, our physicians ordered 1 or more laboratory tests. Treatment adherence was 57% at 1 year.
authors.affiliation: Department of Rheumatology, Geisinger Medical Center, MC 21-52, 100 North Academy Avenue, Danville, PA 17822, USA. tpolenginski@geisinger.edu
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Olenginski
authors.forename: Jana L
authors.initials: JL
authors.lastname: Antohe
authors.forename: Elaine
authors.initials: E
authors.lastname: Sunderlin
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Harrington
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D016903:Drug Monitoring
chemical_list: D050071:Bone Density Conservation Agents
references.citation: J Clin Rheumatol. 2005 Apr;11(2):68-71
references.pmid: 16357705
references.citation: Mayo Clin Proc. 2006 Mar;81(3):353-73
references.pmid: 16529140
references.citation: Arch Intern Med. 2003 Oct 13;163(18):2165-72
references.pmid: 14557214
references.citation: J Clin Densitom. 2006 Jan-Mar;9(1):72-7
references.pmid: 16731434
references.citation: JAMA. 1999 Oct 13;282(14):1344-52
references.pmid: 10527181
references.citation: Ann Intern Med. 1998 Jun 15;128(12 Pt 1):996-9
references.pmid: 9625686
references.citation: Osteoporos Int. 2000;11(1):83-91
references.pmid: 10663363
references.citation: J Clin Densitom. 2008 Jan-Mar;11(1):75-91
references.pmid: 18442754
references.citation: J Bone Joint Surg Am. 2003 Sep;85(9):1837-43
references.pmid: 12954849
references.citation: N Engl J Med. 2001 May 10;344(19):1434-41
references.pmid: 11346808
references.citation: JAMA. 1999 Aug 18;282(7):637-45
references.pmid: 10517716
references.citation: Osteoporos Int. 2008 Apr;19(4):449-58
references.pmid: 18292975
references.citation: J Clin Densitom. 2004 Spring;7(1):71-6
references.pmid: 14742890
references.citation: N Engl J Med. 2007 May 3;356(18):1809-22
references.pmid: 17476007
references.citation: Am J Med. 2000 Sep;109(4):267-76
references.pmid: 10996576
references.citation: Arch Intern Med. 2007 Oct 22;167(19):2110-5
references.pmid: 17954806
references.citation: J Bone Miner Res. 2004 Aug;19(8):1241-9
references.pmid: 15231010
references.citation: Osteoporos Int. 2006;17(9):1428-34
references.pmid: 16865312
references.citation: J Clin Rheumatol. 2005 Apr;11(2):65-7
references.pmid: 16357704
references.citation: Arch Intern Med. 2002 Feb 25;162(4):421-6
references.pmid: 11863474
references.citation: Am J Med. 2005 Nov;118(11):1183-9
references.pmid: 16271898
references.citation: Osteoporos Int. 2002 Mar;13(3):205-10
references.pmid: 11991439
references.citation: Osteoporos Int. 2008 Apr;19(4):581-7
references.pmid: 17924051
references.citation: Arch Intern Med. 2005 Apr 25;165(8):905-9
references.pmid: 15851642
references.citation: J Bone Miner Res. 2007 Mar;22(3):465-75
references.pmid: 17144789
references.citation: Mayo Clin Proc. 2005 Feb;80(2):194-202
references.pmid: 15704774
references.citation: Lancet. 1996 Dec 7;348(9041):1535-41
references.pmid: 8950879
references.citation: Semin Arthritis Rheum. 2006 Apr;35(5):293-305
references.pmid: 16616152
references.citation: JAMA. 1998 Dec 23-30;280(24):2077-82
references.pmid: 9875874
references.citation: Arch Intern Med. 2003 Sep 22;163(17):2052-7
references.pmid: 14504118
references.citation: South Med J. 2006 May;99(5):461-6
references.pmid: 16711307
references.citation: J Clin Endocrinol Metab. 2002 Oct;87(10):4431-7
references.pmid: 12364413
references.citation: J Clin Endocrinol Metab. 2007 Mar;92(3):887-94
references.pmid: 17200172