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Effect of self-referral on bone mineral density testing and osteoporosis treatment.

ABSTRACT: Despite national guidelines recommending bone mineral density screening with dual-energy x-ray absorptiometry (DXA) in women aged 65 years and older, many women do not receive initial screening.To determine the effectiveness of health system and patient-level interventions designed to increase appropriate DXA testing and osteoporosis treatment through (1) an invitation to self-refer for DXA (self-referral); (2) self-referral plus patient educational materials; and (3) usual care (UC, physician referral).Parallel, group-randomized, controlled trials performed at Kaiser Permanente Northwest (KPNW) and Kaiser Permanente Georgia (KPG).Women aged 65 years and older without a DXA in past 5 years.DXA completion rates 90 days after intervention mailing and osteoporosis medication receipt 180 days after initial intervention mailing.From >12,000 eligible women, those randomized to self-referral were significantly more likely to receive a DXA than UC (13.0%-24.1% self-referral vs. 4.9%-5.9% UC, P<0.05). DXA rates did not significantly increase with patient educational materials. Osteoporosis was detected in a greater proportion of self-referral women compared with UC (P<0.001). The number needed to receive an invitation to result in a DXA in KPNW and KPG regions was approximately 5 and 12, respectively. New osteoporosis prescription rates were low (0.8%-3.4%) but significantly greater among self-referral versus UC in KPNW.DXA rates significantly improved with a mailed invitation to schedule a scan without physician referral. Providing women the opportunity to self-refer may be an effective, low-cost strategy to increase access for recommended osteoporosis screening.

SUBMITTER: Warriner AH

PROVIDER: S-EPMC4101066 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Effect of self-referral on bone mineral density testing and osteoporosis treatment.

Warriner Amy H AH Outman Ryan C RC Feldstein Adrianne C AC Roblin Douglas W DW Allison Jeroan J JJ Curtis Jeffrey R JR Redden David T DT Rix Mary M MM Robinson Brandi E BE Rosales Ana G AG Safford Monika M MM Saag Kenneth G KG

Medical care 20140801 8

<h4>Background</h4>Despite national guidelines recommending bone mineral density screening with dual-energy x-ray absorptiometry (DXA) in women aged 65 years and older, many women do not receive initial screening.<h4>Objective</h4>To determine the effectiveness of health system and patient-level interventions designed to increase appropriate DXA testing and osteoporosis treatment through (1) an invitation to self-refer for DXA (self-referral); (2) self-referral plus patient educational materials ...[more]

PMID: 24984211

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Effect of self-referral on bone mineral density testing and osteoporosis treatment.

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Effect of self-referral on bone mineral density testing and osteoporosis treatment.

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