CLINICAL REPORTING TO PRIMARY-CARE PHYSICIANS LEADS TO INCREASED USE AND UNDERSTANDING OF BONE DENSITOMETRY AND AFFECTS THE MANAGEMENT OF OSTEOPOROSIS - A RANDOMIZED TRIAL

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 longe r clinical reports on use, understanding, and acceptance of bone densi tometry 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: Ph ysicians were randomly assigned to receive short technical reports or long clinical reports written by endocrinologists with access to clini cal information. Measurements: Physicians were interviewed by telephon e after receiving at least two reports. Results: Before being intervie wed, 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 phy sicians receiving short reports and 86% of those receiving long report s understood the bone mineral density definition of osteoporosis (P < 0.001). Receiving long reports led to more modifications in the pharma cologic treatment of osteoporosis by gynecologists (19% of patients wh ose reports were short and 61% of patients whose reports were long; P = 0.021) and less confusion about reports by all physicians (36% of ph ysicians receiving short reports and 1% of those receiving long report s; P = 0.003). Conclusions: Clinical reporting of bone densitometry to primary care physicians increased use and understanding of bone densi tometry, changed management of osteoporosis, and was well accepted. It may help achieve appropriate use of bone densitometry and may allow c onvenient dissemination of information on osteoporosis.