Patterns of medication use before and after bone densitometry: Factors associated with appropriate treatment

Objective. We examined the medications used by women before and after bone densitometry to determine whether patient or physician factors were associa ted with appropriate osteoporosis therapy. Methods. Appropriate osteoporosis treatment was defined as alendronate, eti dronate, calcitonin, or hormone replacement therapy (HRT) for women with an y bone mineral density (BMD) t score < -2.5 or no osteoporosis therapy, exc ept HRT, for women with t scores > -1.0. We observed a cohort of women who underwent bone densitometry at one outpatient osteoporosis clinic. Medical history, medication use, and demographic data were collected at the time of bone densitometry, A followup questionnaire assessed the medication use pa tterns since bone densitometry and attitudes about osteoporosis therapy. Results. We recruited 553 women who underwent bone densitometry in 1996. Th eir mean age was 62 years and 95% were postmenopausal. Prior to bone densit y scans, 27% of patients used HRT, 15% used bisphosphonates, and 6% used ca lcitonin. Scan results and surveys revealed that 40% of patients had BMD be low a t score of -2.5 at any site. Of women with osteoporosis 78% reported taking an appropriate medication after their scans. Patients most likely to receive appropriate treatment were those who understood their bone densito metry results (odds ratio, OR, 2.5; 95% confidence interval, CI, 1.3 to 4.8 ) and patients who were taking an osteoporosis medication (OR 1.9; 95% CI 1 .0 to 3.6). Neither the specialty of the referring physician nor patients' medical history was associated with use of appropriate osteoporosis therapy . Conclusion. Of women with osteoporosis who underwent bone densitometry 78% received appropriate therapy after this test. Patient factors were associat ed with the likelihood that they received appropriate therapy, suggesting t hat strategies aimed at educating patients may improve the use of osteoporo sis medications.