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theses

Osteoporosis affects 54 million people in the United States alone. This common condition remains undiagnosed in many, leading to fractures that impair mobility. One reason is that primary care providers (PCPs) often do not refer patients for a Dual Energy X-Ray Absorptiometry (DEXA) scan, one of the best procedures to assess bone health. Referral rates, as reported by Warriner et al (2014), are as low as from 0.8 to 3.4%. Purpose of the project: To improve referral rates, the primary investigator (PI) implemented an Osteoporosis Risk Assessment Instrument (ORAI), guided by the Knowledge-to-Action framework. Methodology: PI designed both the pre-test and post-test, and recruited English-speaking adults aged from 50 to 89 and who were at risk for OP to complete the survey during routine care at a primary care clinic in the North East New Jersey. PI excluded those who did not meet these criteria: those who already received a DEXA scan, those who had a current diagnosis of OP, those aged younger than 50 years old, those currently on OP medication, and who have no risk factors for OP. PI assessed the demographic data and rate of referral at baseline and one month following the ORAI. Results: A total of 1,771 charts were reviewed (n=1,000 electronic; n=771 paper). 178 patients completed the ORAI survey. 28.1% (n=178) scored high, indicating a need for a DEXA scan referral. Out of the patients who completed the ORAI survey, 20.1% were referred. The referral rate was around 1% (n=1771) before implementation of the ORAI, an increase of 20% (n=178). Implication for Practice: If implemented widely, a large proportion of patients should be referred for DEXA scans, improving their diagnosis and making treatments more effective.

ETD_10418

DNP

Includes bibliographical references

doi:10.7282/t3-gayc-s297

ETD doctoral

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