title: Understanding Referral Patterns for Bone Mineral Density Testing among Family Physicians: A Qualitative Descriptive Study.
abstract: Introduction. Evidence of inappropriate bone mineral density (BMD) testing has been identified in terms of overtesting in low risk women and undertesting among patients at high risk. In light of these phenomena, the objective of this study was to understand the referral patterns for BMD testing among Ontario's family physicians (FPs). Methods. A qualitative descriptive approach was adopted. Twenty-two FPs took part in a semi-structured interview lasting approximately 30 minutes. An inductive thematic analysis was performed on the transcribed data in order to understand the referral patterns for BMD testing. Results. We identified a lack of clarity about screening for osteoporosis with a tendency for baseline BMD testing in healthy, postmenopausal women and a lack of clarity on the appropriate age for screening for men in particular. A lack of clarity on appropriate intervals for follow-up testing was also described. Conclusions. These findings lend support to what has been documented at the population level suggesting a tendency among FPs to refer menopausal women (at low risk). Emphasis on referral of high-risk groups as well as men and further clarification and education on the appropriate intervals for follow-up testing is warranted.
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, ON, Canada M5G 1V7; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada M5G 2A2.
authors.forename: Sarah E P
authors.initials: SE
authors.lastname: Munce
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, ON, Canada M5G 1V7; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada M5G 2A2.
authors.forename: Sonya
authors.initials: S
authors.lastname: Allin
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, ON, Canada M5G 1V7.
authors.forename: Leslie
authors.initials: L
authors.lastname: Carlin
authors.affiliation: Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada M5B 1W8; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6.
authors.forename: Joanna
authors.initials: J
authors.lastname: Sale
authors.affiliation: Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6; Department of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A8; Institute of Clinical Evaluative Sciences, Toronto, ON, Canada M4N 3M5.
authors.forename: Gillian
authors.initials: G
authors.lastname: Hawker
authors.affiliation: Women's College Research Institute, Toronto, ON, Canada M5S 1B2.
authors.forename: Sandra
authors.initials: S
authors.lastname: Kim
authors.affiliation: The Scarborough Hospital, Scarborough, ON, Canada M1P 2V5; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Butt
authors.affiliation: The Scarborough Hospital, Scarborough, ON, Canada M1P 2V5; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7.
authors.forename: Irene
authors.initials: I
authors.lastname: Polidoulis
authors.affiliation: Institute of Clinical Evaluative Sciences, Toronto, ON, Canada M4N 3M5; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7.
authors.forename: Karen
authors.initials: K
authors.lastname: Tu
authors.affiliation: Department of Physical Therapy, University of Toronto, Toronto, ON, Canada M5G 1V7; Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada M5G 2A2; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6; Institute of Clinical Evaluative Sciences, Toronto, ON, Canada M4N 3M5; Women's College Research Institute, Toronto, ON, Canada M5S 1B2.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Jaglal