Public clinical trial registration: http://clinicaltrials.gov/show/NCT01112098. Improving Quality of Osteoporosis Care Through Patient Storytelling.
A randomized trial of a mailed intervention and self-scheduling to improve osteoporosis screening in postmenopausal women†
Article first published online: 19 NOV 2012
Copyright © 2012 American Society for Bone and Mineral Research
Journal of Bone and Mineral Research
Volume 27, Issue 12, pages 2603–2610, December 2012
How to Cite
Warriner, A. H., Outman, R. C., Kitchin, E., Chen, L., Morgan, S., Saag, K. G. and Curtis, J. R. (2012), A randomized trial of a mailed intervention and self-scheduling to improve osteoporosis screening in postmenopausal women. J Bone Miner Res, 27: 2603–2610. doi: 10.1002/jbmr.1720
- Issue published online: 19 NOV 2012
- Article first published online: 19 NOV 2012
- Accepted manuscript online: 26 JUL 2012 02:43PM EST
- Manuscript Accepted: 13 JUL 2012
- Manuscript Revised: 11 JUL 2012
- Manuscript Received: 9 FEB 2012
- RANDOMIZED CONTROLLED TRIAL
Guidelines recommend bone density screening with dual-energy X-ray absorptiometry (DXA) in women 65 years or older, but <30% of eligible women undergo DXA testing. There is a need to identify a systematic, effective, and generalizable way to improve osteoporosis screening. A group randomized, controlled trial of women ≥65 years old with no DXA in the past 4 years, randomized to receive intervention materials (patient osteoporosis brochure and a letter explaining how to self-schedule a DXA scan) versus usual care (control) was undertaken. Outcome of interest was DXA completion. Of 2997 women meeting inclusion criteria, 977 were randomized to the intervention group. A total of 17.3% of women in the intervention group completed a DXA, compared to 5.2% in the control group (12.1% difference, p < 0.0001). When including only those medically appropriate, we found a difference of 19% between the two groups (p < 0.0001). DXA receipt was greater in main clinic patients compared to satellite clinic patients (20.9% main clinic versus 10.1% satellite clinic). The cost to print and mail the intervention was $0.79 per patient, per mailing. The number of women to whom intervention needed to be mailed to yield one extra DXA performed was 9, at a cost of $7.11. DXA scan completion was significantly improved through use of a mailed osteoporosis brochure and the availability for patients to self-schedule. This simple approach may be an effective component of a multifaceted quality improvement program to increase rates of osteoporosis screening. © 2012 American Society for Bone and Mineral Research.