Screening and Diagnosing Osteoporosis Among Postmenopausal Women in Primary Care Settings in Malaysia: A Systematic Review.

As the population of Malaysia is aging, osteoporosis is becoming more common, prompting the development of various clinical practice guidelines for screening and diagnosing in primary care settings. Given the lack of a systematic assessment of recommendations, we aimed to determine the extent between the guidelines and actuarial screening and diagnosing among postmenopausal women in Malaysia. The present research is a systematic review following the Cochrane Handbook for Systematic Reviews and the preferred reporting items for systematic reviews and meta-analyses (PRISMA) for clinical practice guidelines on the screening and diagnosing of osteoporosis in primary care settings (updated January 1, 2022). For this purpose, several databases were searched, including MEDLINE, EMBASE and CINAHL. Medical subject headings search terms were related to diagnosis and treatment of osteoporosis, clinical practice guidelines, primary settings and postmenopausal women. Two authors assessed records following consensus and evidence-based processes and reviewed the quality of identified studies using the Joanna Briggs Institute Critical Appraisal tools. Six cross-sectional studies were included in our review. All of them showed a fair level of osteoporosis screening among postmenopausal women in Malaysia primary care settings. Included studies reported that 50% of participants had been diagnosed as osteopenia or osteoporosis. Advancing age, increase of menopause years, low bone mass index, low calcium intake, low education level and low income are positive indicators for osteoporosis. The diagnosis of osteoporosis is influenced by the accessibility of primary care providers on osteoporosis care and knowledge of osteoporosis among postmenopausal women. This systematic review has confirmed that there was a fair screening status in Malaysia. A renewed effort in primary care is needed to reduce the explicit gap in practice and meet the osteoporosis guideline. However, further reviews are needed to best inform future practice, specifically examine the challenges of primary care providers in osteoporosis management.