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Clinical Reporting to Primary Care Physicians Leads to Increased Use and Understanding of Bone Densitometry and Affects the Management of Osteoporosis: A Randomized Trial

John L. Stock, MD; Catherine E. Waud, MD; James A. Coderre, MS; Judith H. Overdorf, RN, MPH; John S. Janikas, BS; Kathleen M. Heiniluoma; and M. Anne Morris, BS
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From the Osteoporosis Research and Treatment Center, UMass Memorial Health Care, and University of Massachusetts Medical School, Worcester, Massachusetts. Acknowledgments: The authors thank the primary care physicians for their participation and Carol Gaylord for secretarial support. Grant Support: In part by a grant from the Roger Robinson Fund, UMass Memorial Health Care. Requests for Reprints: John L. Stock, MD, Osteoporosis Research and Treatment Center, UMass Memorial Health Care, 119 Belmont Street, Worcester, MA 01605. Current Author Addresses: Drs. Stock and Waud and Mr. Coderre, Ms. Overdorf, Mr. Janikas, Ms. Heiniluoma, and Ms. Morris: Osteoporosis Research and Treatment Center, UMass Memorial Health Care, 119 Belmont Street, Worcester, MA 01605.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;128(12_Part_1):996-999. doi:10.7326/0003-4819-128-12_Part_1-199806150-00006
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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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