title: Are Men at High Risk for Osteoporosis Underscreened? A Quality Improvement Project.
abstract: BACKGROUND
  Osteoporosis is a major cause of morbidity and mortality in both men and women. The mortality rate in men within 1 year of hip fracture is 37.5%, which is 51% higher than in women. Although clear guidelines exist for osteoporosis screening in women, these are less clear for men. The available guidelines recommend screening high-risk men; however, screening does not appear to be a standard practice.
  
  
  OBJECTIVE
  To increase screening rates of osteoporosis in high-risk men in our primary care clinic by 50%.
  
  
  METHODS
  The screening rate of osteoporosis was determined in high-risk male veterans more than 50 years of age enrolled in the resident physician- and nurse practitioner-staffed primary care clinics at a Veterans Affairs Medical Center in Cleveland, OH. High-risk factors included prolonged use of steroids; hypogonadism; and autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and systemic lupus erythematosus, which are known to be associated with osteoporosis. We surveyed health care professional trainees and nurses to explore their barriers to screening for osteoporosis in high-risk men.
  
  
  METHODS
  After creating awareness about the importance of this condition among the health care professionals, we analyzed whether this education had any impact on the screening rate.
  
  
  RESULTS
  The baseline screening rate in high-risk men was 11%. After phased surveys and awareness building, the screening rate increased to 20%.
  
  
  CONCLUSIONS
  Osteoporosis in high-risk men is under-screened. Creating more awareness about the impact of this condition among health professional trainees and nurses can lead to improved screening rates.
authors.affiliation: Internal Medicine Hospitalist for the Cleveland Clinic Foundation in OH. drsamtajain@yahoo.com.
authors.forename: Samta
authors.initials: S
authors.lastname: Jain
authors.affiliation: Chief Resident in Internal Medicine at the Yale Waterbury Hospital in CT. bilori786@gmail.com.
authors.forename: Bilori
authors.initials: B
authors.lastname: Bilori
authors.affiliation: Assistant Professor of Clinical Radiology at the Stonybrook University Hospital in NY. amitgupta0707@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Technology Specialist at Case Western Reserve University and Louis Stoke Cleveland Veterans Administration Medical Center in OH. pete.spanos@va.gov.
authors.forename: Pete
authors.initials: P
authors.lastname: Spanos
authors.affiliation: Physician Director of the Center of Excellence for the Louis Stoke Cleveland Veterans Administration Medical Center in OH. mamta.singh@va.gov.
authors.forename: Mamta
authors.initials: M
authors.lastname: Singh
mesh_terms: D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D058996:Quality Improvement; D018570:Risk Assessment; D011795:Surveys and Questionnaires
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