ODP092 Guideline Adherence for Age-based Screening of Osteoporosis in Men at a Veterans Affairs Medical Center

Abstract

Abstract Background Osteoporosis is one of the leading causes of morbidity and mortality in older women and men. Men with osteoporosis have higher fracture-related morbidity and mortality rates compared to women, but screening rates in men remain much lower. Moreover, there is limited veteran-specific data despite the suggestion that veterans may be at higher risk for osteoporosis. (1) Objective: To assess current dual energy X-ray absorptiometry (DEXA) ordering practices within a veteran cohort. Design: A retrospective cohort study of male veterans aged71-75 years who were evaluated by a primary care provider (PCP) within the last 5 years (n = 13,174). Results DEXAs wereordered for ∼7% of the population (920/13,174), and 91.6% were completed (843/920). Over 60% of completed DEXAs were ordered due to the presence of risk factors (308/843, 36.5%), history of fractures (60/843, 7%), known osteopenia or osteoporosis (59/843, 7%), or osteopenia mentioned on another imaging modality (78/843, 9.3%), while only 33.5% (282/843) were ordered for screening purposes. Of those with DEXA results reported (838/843, 99.4%), 34.5% (289/838) were normal, 51% (427/838) were in the osteopenia range and 14.5% (122/838) were in the osteoporosis range. Regarding DEXAs obtained for screening purposes, 42% (118/282) were normal, 48% (136/282) were in the osteopenia range, and 10% (28/282) were in the osteoporosis range. Conclusions Despite the Endocrine Society and National Osteoporosis Foundation recommending screening men aged ≥70 years, less than 10% of male veterans eligible for osteoporosis screening based on age alone had a DEXA scan. Of those male veterans who received a DEXA for screening purposes, almost 60% were found to have an abnormal result. The lack of screening for osteoporosis in this population has the potential to worsen the disparity in bone health between men and women, and between veterans and non-veterans, making it difficult to determine the scope of a problem which has the potential to cause significant morbidity and mortality.