Clinical Reporting to Primary Care Physicians Leads to Increased Use and Understanding of Bone Densitometry and Affects the Management of Osteoporosis
| Autor: | James A. Coderre, Judith H. Overdorf, Kathleen M. Heiniluoma, Catherine E. Waud, Morris Ma, Janikas Js, John L. Stock |
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| Rok vydání: | 1998 |
| Předmět: |
Bone mineral
Health Knowledge Attitudes Practice medicine.medical_specialty Randomization Bone disease business.industry Osteoporosis General Medicine Primary care medicine.disease law.invention Surgery Absorptiometry Photon Randomized controlled trial law Internal Medicine Physical therapy medicine Humans Managed care Diffusion of Innovation Practice Patterns Physicians' Densitometry business |
| Zdroj: | Annals of Internal Medicine. 128:996 |
| ISSN: | 0003-4819 |
| DOI: | 10.7326/0003-4819-128-12_part_1-199806150-00006 |
| Popis: | 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 longer clinical reports on use, understanding, and acceptance of bone densitometry 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: Physicians were randomly assigned to receive short technical reports or long clinical reports written by endocrinologists with access to clinical information. Measurements: Physicians were interviewed by telephone after receiving at least two reports. Results: Before being interviewed, 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 physicians receiving short reports and 86% of those receiving long reports understood the bone mineral density definition of osteoporosis (P < 0.001). Receiving long reports led to more modifications in the pharmacologic treatment of osteoporosis by gynecologists (19% of patients whose reports were short and 61% of patients whose reports were long; P = 0.021) and less confusion about reports by all physicians (36% of physicians receiving short reports and 1% of those receiving long reports; P = 0.003). Conclusions: Clinical reporting of bone densitometry to primary care physicians increased use and understanding of bone densitometry, changed management of osteoporosis, and was well accepted. It may help achieve appropriate use of bone densitometry and may allow convenient dissemination of information on osteoporosis. |
| Databáze: | OpenAIRE |
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