Clinical reporting to primary care physicians leads to increased use and understanding of bone densitometry and affects the management of osteoporosis. A randomized trial
Osteoporosis Research and Treatment Center; Department of Medicine, Division of Endocrinology & Metabolism; Diabetes and Endocrinology Research Center
Absorptiometry, Photon; *Diffusion of Innovation; *Health Knowledge, Attitudes, Practice; Humans; Osteoporosis; *Physician's Practice Patterns
Life Sciences | Medicine and Health Sciences
BACKGROUND: A major barrier to wider use of bone densitometry has been a lack of reports that are comprehensible to primary care physicians. OBJECTIVE: To compare the effect of short technical reports and longer clinical reports on use, understanding, and acceptance of bone densitometry by primary care physicians and on management of osteoporosis. DESIGN: Randomized trial. SETTING: Osteoporosis center of a community teaching hospital. SUBJECTS: 57 primary care physicians ordering bone mineral density tests with dual x-ray absorptiometry. INTERVENTION: Physicians were randomly assigned to receive short technical reports or long clinical reports written by endocrinologists with access to clinical information. MEASUREMENTS: Physicians were interviewed by telephone after receiving at least two reports. RESULTS: Before being interviewed, physicians receiving short reports ordered a mean +/- SD of 0.72 +/- 0.71 tests per month; those receiving long reports ordered 1.30 +/- 1.21 tests per month (P = 0.002). At the first interview, 30% of physicians receiving short reports and 86% of those receiving long reports understood the bone mineral density definition of osteoporosis (P < 0.001). Receiving long reports led to more modifications in the pharmacologic treatment of osteoporosis by gynecologists (19% of patients whose reports were short and 61% of patients whose reports were long; P = 0.021) and less confusion about reports by all physicians (36% of physicians receiving short reports and 1% of those receiving long reports; P = 0.003). CONCLUSIONS: Clinical reporting of bone densitometry to primary care physicians increased use and understanding of bone densitometry, changed management of osteoporosis, and was well accepted. It may help achieve appropriate use of bone densitometry and may allow convenient dissemination of information on osteoporosis.
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Citation: Ann Intern Med. 1998 Jun 15;128(12 Pt 1):996-9.
Annals of internal medicine
Stock, John L.; Waud, Catherine E.; Coderre, James A.; Overdorf, Judith H.; Janikas, John S.; Heiniluoma, Kathleen M.; and Morris, M. Anne, "Clinical reporting to primary care physicians leads to increased use and understanding of bone densitometry and affects the management of osteoporosis. A randomized trial" (1998). Open Access Articles. 174.