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Published Online, 23 January 2004, www.theannals.com, DOI 10.1345/aph.1D229.
 The Annals of Pharmacotherapy: Vol. 38, No. 3, pp. 473-481. DOI 10.1345/aph.1D229
© 2004 Harvey Whitney Books Company.
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AMBULATORY CARE

Osteoporosis: Point-of-Care Testing

Renee M DeHart, PharmD BCPS

Associate Professor of Pharmacy Practice, Clinical Pharmacy Specialist, McWhorter School of Pharmacy, Medical Center East Family Practice Residency Program, Samford University, Birmingham, AL

English H Gonzalez, MD

Faculty, Community Medicine and Curriculum Development Coordinator, Medical Center East, Family Practice Residency Program

Reprints: Renee M DeHart PharmD BCPS, McWhorter School of Pharmacy, Samford University, 800 Lakeshore Dr., Birmingham, AL 35229-7027, fax 205/726-2669, rmdehart{at}samford.edu

OBJECTIVE: To review the literature concerning the utility of point-of-care (POC) testing devices for the diagnosis and management of osteoporosis.

DATA SOURCES: Articles were identified from a MEDLINE search (1993–June 2003). Additional references were obtained from cross-referencing the bibliographies of selected articles.

STUDY SELECTION AND DATA EXTRACTION: After evaluation of clinical trials and select review articles, articles comparing peripheral dual-energy absorptiometry (pDXA) or quantitative ultrasound (QUS) with central DXA (cDXA) measurements were emphasized in this analysis.

DATA SYNTHESIS: Sensitivity for detecting osteoporosis by QUS or pDXA varies widely (range 35–75%). Using adjusted T-score cutoffs increases sensitivity to 85–95%, at the price of reducing device specificity to 23–49%. Many states require a radiology technician to perform pDXA tests.

CONCLUSIONS: POC testing with peripheral devices should only be considered in areas with limited access to cDXA or for women who initially refuse cDXA testing. T scores of–1.0 or less with POC testing typically require further evaluation via cDXA. Many states require pDXAs to be performed by certified radiology technologists, making QUS use more feasible for pharmacists. POC testing should not be used for assessing response to osteoporosis therapy.

Key Words: osteoporosis, point-of-care testing

Published Online, January 23, 2004. www.theannals.com, DOI 10.1345/aph.1D229

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-04-011-H01


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D. W Grabe, J. Cerulli, J. S Stroup, and M. P Kane
Comparison of the Achilles Express Ultrasonometer with Central Dual-Energy X-Ray Absorptiometry
Ann. Pharmacother., May 1, 2006; 40(5): 830 - 835.
[Abstract] [Full Text] [PDF]


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