An Outreach Intervention Increases Bone Densitometry Testing in Older Women

Authors

  • Thomas D. Denberg MD, PhD,

    1. From the *Department of Medicine, Colorado Health Outcomes Program, and Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
    Search for more papers by this author
  • , Beth A. Myers BA,

    1. From the *Department of Medicine, Colorado Health Outcomes Program, and Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
    Search for more papers by this author
  • Chen-Tan Lin MD,

    1. From the *Department of Medicine, Colorado Health Outcomes Program, and Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
    Search for more papers by this author
  • Anne M. Libby PhD,

    1. From the *Department of Medicine, Colorado Health Outcomes Program, and Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
    Search for more papers by this author
  • , Sung-Joon Min PhD,

    1. From the *Department of Medicine, Colorado Health Outcomes Program, and Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
    Search for more papers by this author
  • Michael T. McDermott MD,

    1. From the *Department of Medicine, Colorado Health Outcomes Program, and Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
    Search for more papers by this author
  • and , John F. Steiner MD, MPH

    1. From the *Department of Medicine, Colorado Health Outcomes Program, and Department of Psychiatry, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
    Search for more papers by this author

Address correspondence to Thomas D. Denberg, General Internal Medicine, Academic Office Building (AO1), B-180, 12631 East 17th Avenue, P.O. Box 6511, Aurora, CO 80045. E-mail: Tom.Denberg@ucdenver.edu

Abstract

OBJECTIVES: To evaluate the performance of a patient recall intervention that relies on an outreach coordinator with a bachelor's degree to prompt women by mail and telephone about their eligibility for bone densitometry (dual-energy X-ray absorptiometry (DXA)) screening and allow them to schedule an examination without a medical provider visit ahead of time.

DESIGN: Observational.

SETTING: Academic general internal medicine practice.

INTERVENTION: Mail- and telephone-based patient recall for DXA.

PARTICIPANTS: Five hundred sixty-four women aged 65 to 79 at average risk for osteoporosis without a history of DXA.

MEASUREMENTS: Rates of DXA completion and the change in proportion of screened women during a 7-month intervention period, case finding for clinically significant bone loss, frequency of appropriate clinical follow-up, DXA no-show rates compared with usual care, and clinician satisfaction.

RESULTS: Through patient recall, rates of DXA screening rose significantly (P<.001), and the proportion of the eligible clinic population screened increased 13%. Thirty percent of patients had clinically significant bone loss, with almost all of these receiving follow-up. DXA no-show rates were comparable with usual care, and provider acceptance was high.

CONCLUSION: A patient recall intervention substantially increased DXA screening, allowing pharmacological therapy to be started much earlier in some women with significant bone loss. It imposed minimal burden on providers and enhanced patient convenience. This type of program may have utility for additional preventive services.

Ancillary