Understanding Referral Patterns for Bone Mineral Density Testing among Family Physicians: A Qualitative Descriptive...

Area of Science:

• Endocrinology
• Primary Care Medicine
• Health Services Research

Background:

• Inappropriate bone mineral density (BMD) testing, including overtesting in low-risk populations and undertesting in high-risk groups, is a recognized issue.
• Understanding family physicians' (FPs) referral patterns for BMD testing is crucial for optimizing osteoporosis screening.

Purpose of the Study:

• To investigate the referral patterns for bone mineral density (BMD) testing among family physicians in Ontario.
• To identify factors influencing decisions regarding osteoporosis screening referrals.

Main Methods:

• A qualitative descriptive study design was employed.
• Semi-structured interviews were conducted with 22 family physicians in Ontario.
• Inductive thematic analysis was used to analyze the transcribed interview data.

Main Results:

• A lack of clarity exists regarding osteoporosis screening guidelines, particularly for men and appropriate follow-up testing intervals.
• There is a tendency for baseline BMD testing in healthy, postmenopausal women, indicating potential overtesting in low-risk individuals.
• Under-referral of high-risk patients and men for BMD testing was observed.

Conclusions:

• Findings align with population-level data suggesting FPs may over-refer low-risk menopausal women for BMD testing.
• Enhanced education and clear guidelines are necessary to emphasize referral of high-risk groups and men.
• Clarification on appropriate screening and follow-up intervals for bone mineral density testing is warranted.