RANDOMIZED TRIAL OF OSTEOPOROSIS SCREENING - USE OF HORMONE REPLACEMENT THERAPY AND QUALITY-OF-LIFE RESULTS

Background: Screening perimenopausal women for low bone density has ye t to be tested in a randomized trial. The effect of screening on the u se of hormone replacement therapy (HRT) and the subsequent quality of life in these women is unknown. The purpose of this study was to asses s the effect of a screening program on HRT use and quality of life. Me thods: A random sample of women aged 45 to 54 years and living within 32 km of Aberdeen, Scotland, was selected from the community health in dex. Subjects were further randomized to screening or no screening usi ng the design of Zelen. Two years after randomization, a questionnaire follow-up was mailed to both groups to assess HRT use and quality-of- life scores. Results: Use of HRT was higher in the screened group (30% vs 24%; difference, 6%; 95% confidence interval, 1%-11%; P=.02). A mu ltivariate analysis indicated that the odds of using HRT for a screene d woman whose measurement for bone mineral density was in the lowest q uartile was 2.54 (95% confidence interval, 1.74-3.71) greater than tha t of an unscreened woman. Screening and subsequent HRT use did not hav e any detectable effects-positive or adverse-on women's quality of lif e. Conclusion: Screening for low bone density significantly increases the use of HRT in this population but without any immediate adverse or positive effects on quality of life.