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Oshien Lekhwani, DO

  • Graduate 2023
Scholarly Research Project

Using Patient Letter Reminders to Increase the Rates of Osteoporosis Screening at the Shadyside Family Health Center

Oshien Lekhwani, DO; Michele Hebda, PharmD, BCPS; Barry Coutinho, MBBS; Alan Finkelstein, MD

Osteoporosis is a chronic, progressive disease characterized by low bone mass, bone fragility, and a consequent increase in fracture risk. Osteoporotic fractures are associated with increased risk of disability, nursing home placement, total health care costs, and mortality. In the United States, more that 10 million people have osteoporosis. At the Shadyside Family Health Center (SFHC), as of April 2022, there were 361 women aged 65 to 75 and 169 women (47%) were due for dual-energy x-ray absorptiometry (DXA) scans. This project aimed to determine if sending out patient letter reminders would be an effective method to increase rates of DXA scans at the SFHC. A recent study from 2021 completed at Penn State Hershey Medical Center also found that sending an automatic letter reminder regarding osteoporosis screening to high-risk patients led to a significant increase in osteoporosis screening rates. Hypothesis: If reminder letters regarding osteoporosis screening are sent to patients, then there should be a subsequent significant increase in DXA scans done at the SFHC.

Initial patient charts were reviewed to determine patients aged 65-70 years old who were overdue for DXA. Then 114 individual letters were sent out via EPIC EMR to those patients. 55 letters were not sent due to various reasons. Patient charts were reviewed again to determine how many patients got their DXA scans done within 6 months of the letter being sent.

28 out of the 114 women (24.8%) that received the letter had their DXA scans done within 6 months of receiving it. The completion rate of completed DXA scans increased from 47% to 61%. However, 20 out of the 55 women (36%) that did not receive the letter also had their DXA scans done prior to the start of the project without receiving a letter.

Sending out patient letter reminders did not increase rates of DXA scans at the Shadyside Clinic.

Milton, Canada