JAMDA
Volume 9, Issue 3 , Pages 190-193, March 2008

Osteoporosis is Underdiagnosed in Skilled Nursing Facilities: A Large-Scale Heel BMD Screening Study

  • F. Michael Gloth III, MD, FACP, AGSF, CMD

      Affiliations

    • Johns Hopkins University School of Medicine, University of Maryland School of Medicine, Victory Springs Senior Health Associates, Reisterstown, MD
    • ,
  • William Simonson, PharmD, FASCP, CGP

      Affiliations

    • Independent Consultant Pharmacist, Suffolk, VA.
    • Corresponding Author InformationAddress correspondence to William Simonson, PharmD, FASCP, CGP, PO Box 5446, Suffolk, VA, 23435.

Objective

To investigate the common assertion that osteoporosis is underdiagnosed in the skilled nursing facility setting.

Methods

Skilled nursing facilities participated in a nationwide heel-screening study conducted by their local consultant pharmacists. The nursing facility residents were categorized into 4 age groups: 59 years and younger; 60 to 69 years; 70 to 79 years; and 80 years and older. Residents were screened on a voluntary basis. Heel scanning was performed using a peripheral dual-energy x-ray absorptiometry (pDXA) machine, and the data were collected by an independent contractor (On-Site Wellness). Residents were grouped by low, moderate, or high risk for osteoporosis based on their bone mineral density (BMD) T-scores. Bedridden patients, patients with a short life expectancy, and those currently receiving osteoporosis therapy were excluded from the study.

Results

A total of 34,486 residents of skilled nursing facilities in 26 states were screened, 7728 (22.4%) of whom were grouped as low risk, 12,095 (35.1%) as moderate risk, and 14,663 (42.5%) as high risk for osteoporosis and related fracture. Findings by state were comparable to those for the total study population.

Conclusion

This large-scale heel-screening study suggests a considerable prevalence of undiagnosed osteoporosis (as measured by peripheral DXA scans) in skilled nursing facilities, underscoring the need for more vigilant awareness of fracture risk in these patients.

Keywords: Osteoporosis, skilled nursing facilities, peripheral DXA scan

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 The authors received editorial support in the preparation of this article funded by The Alliance for Better Bone Health (Procter & Gamble Pharmaceuticals and Sanofi-Aventis U.S., Inc). The authors, however, were fully responsible for all content and editorial decisions and received no financial support or other form of compensation related to the development of the article.The study was funded by Procter & Gamble Pharmaceuticals.

PII: S1525-8610(07)00527-0

doi:10.1016/j.jamda.2007.12.003

JAMDA
Volume 9, Issue 3 , Pages 190-193, March 2008

Article Tools

* Image Usage & Resolution