Schrager S, Plane M B, Mundt M P, Stauffacher E A
Department of Family Medicine, University of Wisconsin, Madison 53715, USA.
J Fam Pract. 2000 Dec;49(12):1099-103.
Our goal was to determine how often primary care providers discussed osteoporosis prevention and calcium intake with women during their health maintenance examinations.
A total of 449 women aged 18 to 65 years participated in exit interviews immediately following a health maintenance examination at 1 of 8 Wisconsin family practice clinics.
Forty-six percent of these women reported discussing osteoporosis with their providers during their visit, and 51% reported discussing calcium intake. A total of 61% reported discussing either osteoporosis or calcium intake during the visit. Some providers were able to discuss these topics with more than 90% of their patients. A logistic regression model showed that providers were less likely to discuss either of these issues with women younger than 40 years (P=.019); they were more likely to discuss them with women older than 60 years (P=.002) than with women aged 40 to 60 years; and women providers were significantly more likely to discuss either issue (P=.004).
Primary care providers are in a good position to counsel women of all ages about their potential for avoiding osteoporosis and to recommend prevention strategies. The United States Preventive Services Task Force recommends that all women be counseled on adequate calcium intake yearly after the age of 18 years. Provider education and institutional changes may increase the frequency of this counseling for all primary care physicians.
我们的目标是确定基层医疗服务提供者在妇女进行健康维护检查期间,讨论骨质疏松症预防和钙摄入量的频率。
共有449名年龄在18至65岁之间的妇女,在威斯康星州8家家庭医疗诊所中的1家进行健康维护检查后,立即参与了离职面谈。
这些妇女中有46%报告在就诊期间与医疗服务提供者讨论过骨质疏松症,51%报告讨论过钙摄入量。共有61%报告在就诊期间讨论过骨质疏松症或钙摄入量。一些医疗服务提供者能够与超过90%的患者讨论这些话题。逻辑回归模型显示,医疗服务提供者与40岁以下女性讨论这些问题的可能性较小(P = 0.019);与40至60岁女性相比,他们与60岁以上女性讨论这些问题的可能性更大(P = 0.002);女性医疗服务提供者讨论任何一个问题的可能性显著更高(P = 0.004)。
基层医疗服务提供者有很好的条件为各年龄段的女性提供关于预防骨质疏松症可能性的咨询,并推荐预防策略。美国预防服务工作组建议,所有18岁以上的女性每年都应接受关于充足钙摄入量的咨询。对医疗服务提供者的教育和机构变革可能会增加所有基层医疗医生进行此类咨询的频率。