SFEBES2009 Poster Presentations Clinical practice/governance and case reports (96 abstracts)
Assessment of risk factors given in GP referral letters for DEXA imaging
Ghulam Mustafa Shaikh 1 , Mortimer B O’Connor 2 , Jeetandra Rathi 2 , Fredo Lainis 2 , Ursula Bond 2 , Joan Swan 2 , Matthew Murphy 1 & Mark J Phelan 2
1Endocrine Unit, South Infirmary Victoria Hospital, Cork, Ireland; 2Rheumatology Department, South Infirmary Victoria Hospital, Cork, Ireland.
Introduction: Osteoporosis poses a significant public health issue, causing significant morbidity and mortality. It leads to an increased fracture risk through a reduction in the bone mineral density (BMD), disruption of bone microarchitecture, and alteration of the amount and variety of non-collagenous proteins in bone. Treatment aims are to prevent fractures and maintain the quality of life of the aging adult. The advent of the WHO assessment tool ‘Fracture Risk Assessment Tool’ (FRAX®) has been revolutionary in GP assessment of patients regarding need for treatment, need for further evaluation by DEXA imaging and those not requiring any treatment. This study examines GP requests for DEXA imaging and if they contain sufficient details to justify imaging.
Methods: Two hundred randomly chosen GP request letters were analysed using the FRAX® tool. All letters were from April 2007 to July 2008. Resulting data was analysed using the statistical package SPSS.
Results: Of the 200 letters, 4% (n=8) were male and 96% (n=192) were female, with a mean age of 64.3 years. One GP service provided a proforma referral letter with the remaining letters being individually composed. Table 1 shows the percentage of letters containing each of the FRAX® criteria. Of importance only 1 request (not a proforma letter) contained all the details allowing for FRAX® assessment (P<0.005) despite the use of a proforma by one GP service.
| Criteria | Percentage (n value) |
| Age | 100% (n=200) |
| Sex | 100% (n=200) |
| Weight | <1% (n=1) |
| Height | <1% (n=1) |
| Previous fracture | 7% (n=14) |
| Parental hip fracture | 5% (n=10) |
| Current smoker | 6% (n=12) |
| Glucocorticoids | 8% (n=16) |
| Rheumatoid arthritis | 3% (n=6) |
| Secondary osteoporosis | 9% (n=18) |
| Alcohol 3 or more units/day | 2% (n=4) |
Conclusions: The majority of GP referral letters for DEXA imaging do not contain adequate data to make recommendations using the FRAX® tool. Incorporating this data is likely to improve requesting systems for DEXA scanning to GPs.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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