Polinski Jennifer M, Patrick Amanda, Truppo Colleen, Breiner Laura, Chen Ya-Ting, Egan Cathy, Jan Saira, Patel Minal, Weiss Thomas W, Solomon Daniel H
Division of Pharmacoepidemiology and Pharmacoeconomics, 1620 Tremont St, Ste 3030, Boston, MA 02120, USA.
Am J Manag Care. 2006 Jun;12(6):321-5.
Bone mineral density (BMD) testing is a key tool used to diagnose and treat osteoporosis. We assessed the rate of scheduling BMD tests among health plan members at risk for osteoporosis who received interactive voice response (IVR) calls.
Cohort study.
Study patients included persons age 45 years with either a prior fracture or 90 days of glucocorticoid use and all women age 65 years during the 2-year baseline period. The IVR call provided educational content and then offered members an opportunity to transfer to schedule a BMD test. The primary outcome was scheduling a BMD test.
We targeted 1402 health plan members, and 708 (50%) were successfully contacted. Of 54 patients who transferred to schedule a BMD test, only 3 actually did so. Because so few patients scheduled a BMD test, predictors of transfer were examined as a secondary end point. In a multivariate model, only self-reported intention to schedule a BMD test was a significant predictor (odds ratio = 4.4, 95% confidence interval = 2.2, 8.8). Members' age, sex, history of a prior fracture, self-report of a BMD test in the previous 2 years, acknowledgement of barriers to BMD testing, and discussion of BMD testing with one's physician were not related to transferring to schedule a BMD test.
A letter and an IVR call prompted few to schedule a BMD test. More interventions to improve BMD testing should be developed and tested.
骨密度（BMD）检测是用于诊断和治疗骨质疏松症的关键工具。我们评估了在接受交互式语音应答（IVR）呼叫的有骨质疏松症风险的健康计划成员中安排BMD检测的比率。
队列研究。
研究患者包括在2年基线期内有既往骨折史或使用糖皮质激素90天的45岁及以上人群以及所有65岁及以上的女性。IVR呼叫提供了教育内容，然后为成员提供了转接以安排BMD检测的机会。主要结局是安排BMD检测。
我们的目标是1402名健康计划成员，成功联系到了708名（50%）。在54名转接以安排BMD检测的患者中，只有3名实际进行了检测。由于安排BMD检测的患者很少，因此将转接的预测因素作为次要终点进行了检查。在多变量模型中，只有自我报告的安排BMD检测的意愿是一个显著的预测因素（优势比=4.4，95%置信区间=2.2，8.8）。成员的年龄、性别、既往骨折史、过去2年中BMD检测的自我报告、对BMD检测障碍的认知以及与医生讨论BMD检测与转接安排BMD检测均无关。
一封信和一次IVR呼叫促使很少有人安排BMD检测。应开发和测试更多改善BMD检测的干预措施。
