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Related Experiment Videos

Improving osteoporosis screening: results from a randomized cluster trial.

Jennifer Elston Lafata1, Deneil Kolk, Edward L Peterson

  • 1Center for Health Services Research, Henry Ford Health System, Detroit, Michigan 48202, USA. JLAFATA1@HFHS.ORG

Journal of General Internal Medicine
|March 16, 2007
PubMed
Summary

Mailed reminders significantly increased osteoporosis screening for older women. Combining reminders with physician prompts further improved screening rates, though treatment rates showed no significant difference between reminder strategies.

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Area of Science:

  • Geriatric Medicine
  • Preventive Healthcare
  • Health Services Research

Background:

  • Osteoporosis screening rates in women aged 65+ remain suboptimal despite guidelines.
  • Low screening rates necessitate interventions to improve adherence.
  • A randomized trial evaluated mailed reminders and physician prompts to boost screening.

Purpose of the Study:

  • To assess the effectiveness of mailed patient reminders, with and without physician prompts, on osteoporosis screening.
  • To evaluate the impact of these interventions on osteoporosis treatment rates.
  • To identify strategies for improving bone mineral density testing in older women.

Main Methods:

  • A cluster randomized trial involving 15 primary care clinics and 10,354 women aged 65-89.

Related Experiment Videos

  • Clinics were assigned to usual care, mailed reminders, or mailed reminders with physician prompts.
  • Automated data analyzed bone mineral density testing and treatment rates using generalized estimating equations.

    • Main Results:

    • Osteoporosis screening rates were 10.8% (usual care), 24.1% (reminders), and 28.9% (reminders + prompts).
    • Mailed reminders significantly increased testing versus usual care; prompts further enhanced this effect, especially in older patients.
    • Treatment rates were 5.2% (usual care), 8.4% (reminders), and 9.1% (reminders + prompts); usual care patients were less likely to be treated.

    Conclusions:

    • Mailed reminders, alone or with physician prompts, effectively increase osteoporosis screening in primary care.
    • These interventions improve screening rates among insured women aged 65 and older.
    • While screening improved, further strategies may be needed to significantly boost osteoporosis treatment rates.