Adherence of academic geriatric practitioners to osteoporosis screening guidelines.
OBJECTIVES: To examine the bone mineral density (BMD) testing habits of geriatricians and geriatric fellows at the University of Connecticut fellowship training program to evaluate their adherence screening guidelines. DESIGN: Retrospective chart review. SETTING: University based academic geriatric practice in Farmington, CT. PARTICIPANTS: Chart review of two hundred female patients over age 65 under care of seven faculty geriatricians and eight geriatric fellows in training. MEASUREMENTS: Data collected included BMD testing status, patient's osteoporosis risk factors and functional status. RESULTS: Physicians ordered BMD tests in 151 (76%) patients; 128 (64%) had a bone mineral density test within three years. A personal history of fracture was the only osteoporosis risk factor that correlated to higher rates of osteoporosis testing. Physicians were more likely to order BMD screening in younger patients (92% in 65-74 vs. 74% in ages 85+, P=.031), patients independent in activities of daily living (72% vs. 32, P=.002), and patients without dementia (70% vs.37%, p=.007). BMD testing results found 82% with osteopenia or osteoporosis. CONCLUSIONS: A geriatric group that is highly attuned to bone health demonstrated more optimal adherence to OP testing guidelines for all "at-risk" older women and better than reported previously. Functional status more strongly predicted BMD testing than osteoporosis risk factors. This study suggests that with improved physician education and familiarity with the disease, high rates of BMD testing for earlier identification of geriatric patients at risk for osteoporosis are achievable.