Remote Bone Health Service for Osteoporosis Screening in High-Risk Men: A Cluster Randomized Clinical Trial
Authors' conclusion
This cluster randomized clinical trial found that the BHS model was associated with significantly improved osteoporosis screening, treatment, and adherence compared with usual care, with high patient and clinician acceptance. Selecting men for osteoporosis screening based on clinical risk factors before a fracture has occurred has a high screening yield. This approach requires validation in other clinical settings and with longer follow-up to determine impact on fractures.
Study context
- Population
- Male veterans aged 65 to 85 years with ≥1 fracture risk factor and no prior fractures, 39 primary care teams in 2 Veterans Affairs (VA) Health Systems; mean (SD) age 73.3 (5.3) years, 40.4% Black, 56% White39 primary care teams
- Participants
- 3,112 veterans
- Comparison
- Centralized remote bone health service vs usual care
- Bone health service (BHS)n = 1,688
- Usual caren = 1,424reference
- Primary endpoint
- DXA screening rates, osteoporosis treatment, persistence and adherence
Methodological detailscluster randomized, 2 VA Health Systems, 39 primary care teams
- Cluster randomized
- 2 VA Health Systems
- 39 primary care teams
Primary result
As reported in the abstract
P < 0.001
Further findings
Mean
| Outcome | BHS | Usual care | P value |
|---|---|---|---|
| Mean femoral neck T-score, random subset · 2 years after team initiation | −0.55 | −0.70 | P = 0.04 |
Osteopenia or osteoporosis among those screened
- Osteopenia or osteoporosis among those screened
- 441 (51.1%)
Osteoporosis treatment initiation, adherence and persistence in BHS · 2 years of follow-up
- Initiated osteoporosis treatment (BHS)
- 157 (84.4%)
- Adherence: mean subsequent days covered (BHS)
- 91.7%
- Persistence: mean (SD) days (BHS)
- 657 (366)
Original publication
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