Journal Article

Factors Associated with Treatment Initiation after Osteoporosis Screening

Renee M. Brennan, Jean Wactawski-Wende, Carlos J. Crespo and Jacek Dmochowski

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 160, issue 5, pages 475-483
Published in print September 2004 | ISSN: 0002-9262
Published online September 2004 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwh245
Factors Associated with Treatment Initiation after Osteoporosis Screening

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The prevalence of osteoporosis and factors associated with treatment initiation after detection of osteoporosis were determined for previously unscreened, postmenopausal women. Dual-energy x-ray absorptiometry screening was conducted in 1997–2000 as part of an ancillary study of the Buffalo, New York, center of the Women’s Health Initiative Observational Study. A total of 945 women were previously unaware of their bone density, although, for 344 (36.4%), osteoporosis was newly detected through screening (T-score ≤ –2.5). Of those women, 250 (72.7%) discussed the results with a health care provider, and 140 (56.0%) initiated treatment after doing so. In multivariate logistic regression analyses, factors associated with treatment initiation were T-score (odds ratio (OR) = 0.39 per unit increase, 95% confidence interval (CI): 0.23, 0.67), routine medical care more often than yearly (OR = 2.08, 95% CI: 1.12, 3.86), college education (OR = 2.58, 95% CI: 1.25, 5.31), family income of ≥$50,000 (OR = 2.06, 95% CI: 1.03, 4.14), and discussing screening results with a gynecologist (OR = 3.20, 95% CI: 1.33, 7.67). These findings suggest that many postmenopausal women are unaware of their bone density and could benefit from screening. In this study, approximately half of the women with osteoporosis initiated treatment after screening. Disease severity, medical care frequency, education, income, and physician type predicted treatment initiation.

Keywords: bone density; densitometry; diagnosis; drug therapy; mass screening; osteoporosis, postmenopause; risk factors; Abbreviations: CI, confidence interval; DXA, dual-energy x-ray absorptiometry; OR, odds ratio.

Journal Article.  5257 words.  Illustrated.

Subjects: Public Health and Epidemiology

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