Medical College of Wisconsin
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A randomized study of the effect of 5-year and lifetime hip fracture risk information on physician recommendations for management of low bone density. J Clin Densitom 2007 Oct-Dec;10(4):370-5 PMID: 17888700 PMCID: PMC4098647

Pubmed ID

17888700

Abstract

Although risk prediction tools providing absolute fracture risk information are currently under development, little is known about US physicians' current thresholds for osteoporosis treatment or the potential effect of fracture risk information on treatment decisions. To investigate this, a random sample of US primary care physicians was surveyed. Treatment recommendations for 4 patient scenarios depicting postmenopausal women of varying ages, weights, and bone mineral density (BMD) were elicited. Physicians were randomly assigned to receive all scenarios with either a basic BMD report or an augmented BMD report containing 5-yr and lifetime absolute hip fracture risk estimates. Over 95% of physicians recommended prescription pharmacologic treatment of a 70-yr-old patient with osteoporosis. For 3 scenarios depicting women with T-scores of -1.01, treatment recommendations ranged from 30% to 44%. There were no statistically significant differences between physicians who received augmented and basic BMD reports, although those with augmented BMD reports were less likely to recommend prescription treatments. Physician specialty had inconsistent and small effects on recommendations. We conclude that nearly all of a random sample of US primary care physicians recommend pharmacologic treatment of osteoporosis, but a substantial minority also recommend treatment for patients who would not fit current guidelines. A BMD report including absolute hip fracture risk estimates did not change treatment recommendations.

Author List

Neuner JM, Laud PW, Schapira MM

Authors

Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Joan Neuner MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-36048976588   5 Citations

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Bone Density
Female
Health Planning Guidelines
Hip Fractures
Humans
Male
Middle Aged
Osteoporosis, Postmenopausal
Physicians
Physicians, Family
Postmenopause
Practice Patterns, Physicians'
Risk
Surveys and Questionnaires
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6