DENVER — Women who are encouraged to self-schedule dual-energy x-ray absorptiometry scans via mailed brochures and letters undergo more scans than do those in usual practice, but it is still not a silver bullet strategy for identifying women with osteoporosis.
In study of 3,734 women, mailings of an educational osteoporosis brochure and a letter providing the opportunity to self-schedule increased the percentage of women receiving dual-energy x-ray absorptiometry (DXA) scans by 13% versus routine care, Dr. Amy Warriner and her coinvestigators reported in a poster presented at the annual meeting of the American Society for Bone Mineral Research.
The study involved 28 primary care physicians at the University of Alabama at Birmingham. The researchers identified women aged 65 years or older who had not had a DXA scan in the past 4 years, and were under the care of a university primary care provider.
The participating providers were randomized to provide an intervention or not. Intervention-group physicians mailed brochures containing information about osteoporosis and fracture risk. The brochures were created using patient feedback from focus groups. Each mailing included a letter providing patients with the opportunity to self-schedule a DXA scan. Two mailings were sent to each woman.
In all, 665 women were randomized into the intervention group and 3,069 into the control group. A total of 115 women in the intervention group were determined by their primary care provider not to be medically appropriate for DXA testing. Brochures and letters were mailed to the remaining 550 women.
In the intervention group, 19% of women received DXA scans. Half of these were self-scheduled and half were scheduled by the provider. In comparison, only 6% of women in the control group had DXA scans. DXA scan self-scheduling and receipt was 13% better with a mailing intervention when compared with normal practice. “However, more potent strategies will still be needed to further improve DXA screening rates,” wrote Dr. Warriner, professor of medicine in the division of endocrinology and metabolism at the university.
The study was funded in part by Procter & Gamble, which comarkets the osteoporosis drug risedronate (Actonel). Dr. Warriner reported a significant financial relationship with Amgen Inc., which is developing the osteoporosis drug denosumab. Her coinvestigators reported significant financial relationships with a number of pharmaceutical companies that make osteoporosis drugs.