Abstract
Purpose: Implement and evaluate a screening protocol for osteoporosis in the primary care setting.|Background: Osteoporosis is a skeletal disorder characterized by bone mass deterioration, leading to frailty of bones and increased fracture risk. Therefore, screening and detection in the primary care setting is imperative to prevent fractures.|Sample/Setting: Women ages 65 and over visiting a community-based primary care clinic that primarily serves a vulnerable patient population.|Methods: Quality improvement project implementing a protocol to identify women eligible for bone density tests and to refer them appropriately for those tests.|1.Performed a retrospective chart review over a specific 12-week timeframe in the previous year, 2019, to determine the percentage of women 65 years and over who have had a DXA scan and identify the percentage of DXA scans that were ordered and never completed.|2. Presented the providers with education to update them on risk factors for low bone mineral density, screening methods, outcomes of screening, and resources for management.|3.Supplied the clinic with patient education to provide to patients who have a DXA ordered.|4.Implemented the protocol for a 12-week timeframe that all women 65 years and over who are there for their annual physical receive an order for a DXA scan if they have not already had one since
turning 65 years of age.|Results: The providers at the project site were compliant and ordered DXA scans on 100% of eligible women in both the retrospective chart review period and the implementation period. Rates of osteoporosis and osteopenia were lower than the general population, 25.1% and 52.3%, respectively, compared to 9.09% and 18.18% in 2020 and 0% and 8.33% in 2019.|Conclusion: Osteoporosis is a prevalent disease that must be routinely screened for in the primary care setting to prevent osteoporotic bone fractures that have high rates of morbidity and mortality. At this specific clinic, providers were thoroughly ordering DXA scans on all eligible women. Patient education may have played a role in a slightly increased patient follow-through with diagnosis. The patient education is a sustainable intervention that could even be added into the electronic health record in the future when a patient has a DXA ordered. Additionally, with the help of the electronic health record, the providers were able to accurately order DXA scans on all eligible women, as they were prompted to order when appropriate. This protocol with included patient education were beneficial in increasing patient adherence to bone density screening.