Screening for Osteoporosis in Inflammatory Bowel Disease Patients at a Tertiary IBD Clinic

Patients with Inflammatory bowel disease (IBD) are at an increased risk of osteoporosis. There are limited studies internationally showing low screening rates for osteoporosis in IBD patients. There are no studies of osteoporosis screening in an Australian IBD cohort.

To determine the screening rate of osteoporosis in patients with IBD in an Australian tertiary IBD clinic using an extensive risk factor assessment.

A retrospective clinical audit; 252 individual patient records were reviewed from IBD clinic lists. A hybridized screening criterion was created from the European Crohn's and Colitis Organisation, British Society of Gastroenterology and Royal Australian College of General Practitioners guidelines. If patients were not up to date with screening, they were assessed as to whether they had met screening criteria during 2020/2021 and if they were recommended for a dual energy x-ray absorptiometry (DEXA) scan. If patients met criteria, DEXA scan results were collated.

173 patients with IBD were included, 23 patients were up to date with screening and 150 required risk assessment. 101 patients met screening criteria, 12 had a DEXA completed during the study period. In the 35 DEXAs completed before or during the study, 37% showed osteoporosis, 40% showed osteopenia and 23% were normal.

A minority of patients who were identified as at risk of osteoporosis had a DEXA scan completed. Rates of reduced bone mineral density were high in the DEXA scans completed. Future directions should focus on validating expanded Medicare criteria to ensure at-risk patients may be screened.