Bisphosphonate use and health history questionnaire

The health history form is a rapid, time-honored method used by practitioners to assess a patient's medical history before treatment. Because of increased reports of bisphosphonate-related osteonecrosis of the jaws (BRONJ), we investigated the percentage of our patients taking oral bisphosphonates who actually reported taking the medication on our health history form. A questionnaire inquiring about bisphosphonate use was sent to 1,400 female patients who had undergone implant placement in the last five years. A total of 500 responses were received; of these, 112 reported they used bisphosphonates. We then reviewed the charts of the 112 patients to determine the percentage of patients who had included bisphosphonate use in their health history form. Only 35% of our patients who were using bisphosphonates had reported taking bisphosphonates on the health history form. With the difficulties in treating BRONJ, we strongly suggest including direct questions concerning bisphosphonate use in the medical history form so practitioners can identify the patient population that is at risk and can modify the treatment plan to avoid potentially disastrous clinical situations.