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Impact of a primary care physician workshop on osteoporosis medical practices

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Abstract

Summary

Attendance at a fragility-fractures-prevention workshop by primary care physicians was associated with higher rates of osteoporosis screening and treatment initiation in elderly female patients and higher rates of treatment initiation in high-risk male and female patients. However, osteoporosis management remained sub-optimal, particularly in men.

Introduction

Rates of osteoporosis-related medical practices of primary care physicians exposed to a fragility-fractures-prevention workshop were compared with those of unexposed physicians.

Methods

In a cluster cohort study, 26 physicians exposed to a workshop were matched with 260 unexposed physicians by sex and year of graduation. For each physician, rates of bone mineral density (BMD) testing and osteoporosis treatment initiation among his/her elderly patients 1 year following the workshop were computed. Rates were compared using multilevel logistic regression models controlling for potential patient- and physician-level confounders.

Results

Twenty-five exposed physicians (1,124 patients) and 209 unexposed physicians (9,663 patients) followed at least one eligible patient. In women, followed by exposed physicians, higher rates of BMD testing [8.5% versus 4.2%, adjusted OR (aOR) = 2.81, 95% CI 1.60–4.94] and treatment initiation with bone-specific drugs (BSDs; 4.8% vs. 2.4%, aOR = 1.95, 1.06–3.60) were observed. In men, no differences were detected. In patients on long-term glucocorticoid therapy or with a previous osteoporotic fracture, higher rates of treatment initiation with BSDs were observed in women (12.0% vs. 1.9%, aOR = 7.38, 1.55–35.26), and men were more likely to initiate calcium/vitamin D (5.3% vs. 0.8%, aOR = 7.14, 1.16–44.06).

Conclusions

Attendance at a primary care physician workshop was associated with higher rates of osteoporosis medical practices for elderly women and high-risk men and women. However, osteoporosis detection and treatment remained sub-optimal, particularly in men.

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Acknowledgements

This study was funded by the Consortium lavallois de recherche en santé et services sociaux. Lyne Lalonde, Sylvie Perreault, and Lucie Blais are research scholars who receive financial support from the Fonds de recherche en santé du Québec. We thank Chantal Legris for her assistance in the preparation of this article.

Financial disclosure

Consortium lavallois de recherche en santé et services sociaux.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada

    M.-C. Laliberté, S. Perreault, A. Dragomir, L. Blais & L. Lalonde

  2. Research Team in Primary Care, Hôpital Cité-de-la-Santé, Centre de santé et de services sociaux de Laval, 1755 René-Laennec Blvd., Room D-S080, Laval, QC, H7M 3L9, Canada

    M.-C. Laliberté, J. Goudreau & L. Lalonde

  3. Faculty of Nursing, University of Montreal, Montreal, QC, Canada

    J. Goudreau

  4. Faculty of Medicine, Department of Family Medicine, University of Montreal, Montreal, QC, Canada

    I. Rodrigues

  5. CLSC-CHSLD du Marigot de Laval, Laval, QC, Canada

    I. Rodrigues & D. Corbeil

  6. Régie régionale de la santé et des services sociaux de Laval, Laval, QC, Canada

    N. Damestoy

  7. Sanofi-Aventis Endowment Chair in Ambulatory Pharmaceutical Care, Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada

    L. Lalonde

Authors
  1. M.-C. Laliberté
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  2. S. Perreault
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  3. A. Dragomir
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  4. J. Goudreau
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  5. I. Rodrigues
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  6. L. Blais
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  7. N. Damestoy
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  8. D. Corbeil
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  9. L. Lalonde
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Corresponding author

Correspondence to L. Lalonde.

Appendix A

Appendix A

Table 3 ICD-9 diagnostic codes and other information used to identify history of fracture, chronic diseases associated with osteoporosis or an increased risk of fracture, metabolic disorders, and malabsorption state in study patients
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Laliberté, MC., Perreault, S., Dragomir, A. et al. Impact of a primary care physician workshop on osteoporosis medical practices. Osteoporos Int 21, 1471–1485 (2010). https://doi.org/10.1007/s00198-009-1116-6

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  • DOI: https://doi.org/10.1007/s00198-009-1116-6

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