An outreach intervention increases bone densitometry testing in older women

Area of Science:

• Gerontology
• Preventive Medicine
• Health Services Research

Background:

• Osteoporosis screening with bone densitometry (dual-energy X-ray absorptiometry (DXA)) is crucial for women aged 65-79.
• Low screening rates can delay diagnosis and treatment of osteoporosis.
• Effective patient recall strategies are needed to improve adherence to screening guidelines.

Purpose of the Study:

• To assess the effectiveness of a patient recall intervention for bone densitometry (DXA) screening.
• To evaluate the impact of a mail- and telephone-based recall system managed by an outreach coordinator.
• To determine if the intervention improves screening rates and patient outcomes without increasing provider burden.

Main Methods:

• An observational study was conducted in an academic general internal medicine practice.
• A mail- and telephone-based patient recall intervention targeted 564 women aged 65-79 at average risk for osteoporosis.
• Key metrics included DXA completion rates, proportion screened, detection of bone loss, follow-up rates, no-show rates, and clinician satisfaction.

Main Results:

• Patient recall significantly increased DXA screening rates (P<.001), with a 13% rise in the eligible population screened.
• Clinically significant bone loss was identified in 30% of patients, with nearly all receiving appropriate follow-up.
• DXA no-show rates were similar to usual care, and clinician satisfaction was high.

Conclusions:

• A patient recall intervention effectively boosted DXA screening rates, enabling earlier initiation of treatment for bone loss.
• The program enhanced patient convenience and imposed minimal burden on healthcare providers.
• This recall model demonstrates potential utility for implementing other preventive health services.