[Indication of bone densitometry in women over 40 years of age]
Mc Moreno Girao1, F Centelles Mañosa, E Jovell Fernández
1Centro Atención Primaria Sant Llàtzer, Unidad Docente de Medicina Familiar y Comunitaria del Consorcio Sanitario de Terrassa, Barcelona, España. 24728mmg@comb.es
Objective:
To evaluate the indication of bone densitometry (BD) and to know the prevalence of risk factors (FR) for osteoporotic fracture in primary care.
Design:
Cross-sectional, descriptive study.
Setting:
Urban centre of health of Terrassa, Barcelona (52.000 h).
Participants:
Women over 40 years old than went to urgencies of the centre selected by consecutive sampling stratified by age (n=416).
Main Measurements:
Registry of FR for osteoporotic fracture according to the criteria of the Agència d'Avaluació de Tecnologies Mèdiques (AATM), hygienic-dietetic recommendations received and made BDs.
Results:
The average age was of 60+/-13 years. The FR for osteoporotic fracture more prevalence were: low calcium intake (32.1%), increased age (27.5%), no lactation (24.9%), and precocious menopause (16.4%). They had received dietetic recommendations 35.7%, of exercise 65.5% and solar exhibition 18.1%. Of the 177 (42.7%) cases in that the BD was indicated only it made in 45 (25.4%) and of 237 (57.3%) without indication of BD they were made 41 (17.2%). To have made BD is related of statistically significant way to antecedent of osteoporotic fracture (P<.001) and to iatrogenic menopause (P<.001). The 41.2% of the BDs were asked for by the primary care physician, the 34.1% by the rheumatologist and the 16.5% by the gynaecologist. The indication of BD varies between the different scientific societies: AATM 42.7%, semFYC 45.7%, FORE 49.8%, SER 61.1%, and NOF 64.3%.
Conclusions:
Although FR of prevalence osteoporosis are most modifiable from primary care, a low degree of advice exists on healthful habits of life. A low accomplishment of BDs is detected and half is not adapted its indications according to the criteria of the AATM. There is great variability in the indication of BD between the different scientific societies.
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