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Adult Internal Medicine Pharmacy Resident, Virginia Commonwealth University Medical Center; Clinical Instructor, School of Pharmacy, Virginia Commonwealth University, Richmond, VA
Clinical Associate Professor, School of Pharmacy, University of North Carolina, Chapel Hill, NC
Reprints: Dr. Summers, Virginia Commonwealth University Medical Center, Smith Bldg., Rm. 351, 410 N. 12th St., PO Box 980533, Richmond, VA 23298-0533, fax 804/828-8359, ksummers{at}vcu.edu
BACKGROUND: Osteoporosis-associated fractures burden both individuals and the overall healthcare system. Bone mineral density (BMD) screening remains the gold standard measure for identifying patients at risk.
OBJECTIVE: To determine the impact of convenient, pharmacist-led BMD screening and counseling sessions on identification and education of patients at risk for or with osteoporosis.
METHODS: Nonpregnant persons >18 years of age were eligible for enrollment in this descriptive study. At an urban retail pharmacy, participants underwent risk factor assessment, peripheral BMD scanning, and personalized counseling. At 3 and 6 months after screening, subjects were questioned by telephone regarding any subsequent primary care provider (PCP) interactions, as well as any behaviors initiated and/or medications modified.
RESULTS: Of the 102 subjects screened, 22.6% and 11.7% were identified as being at medium risk (T score –1.0 to –2.5) and high risk (T score –2.5 or less) for osteoporosis, respectively. By 6 months, 42.5% of the participants reported increasing their dietary intake of calcium, 29.3% began or increased calcium supplements, and 54.9% positively modified smoking status, exercise level, alcohol consumption, or caffeine intake. Additionally, 24 of 52 subjects who had discussed their results with a PCP by 6 months also received a treatment recommendation. Eighty-nine participants reported the community location increased their likelihood of receiving a BMD scan.
CONCLUSIONS: Overall, pharmacist-led BMD screenings that include individualized counseling sessions appear convenient, accessible, and beneficial for patients. With the establishment of clinical benefit of and positive reception to such screenings, pharmacists can now look toward securing consistent reimbursement for this vital pharmaceutical care service.
Key Words: bone mineral density, community bone mineral density screening, osteoporosis
Published Online, December 21, 2004. www.theannals.com, DOI 10.1345/aph.1E321
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