SAT-538 A Dedicated Inpatient Bone Health Team Improves Screening Rates for Osteoporosis

BACKGROUND: Published reports continue to indicate osteoporosis is under-diagnosed in the United States and most significantly in men, with published rates of screening in primary care settings repeatedly below 20%; this despite that fact that men have been shown to have higher rates of fracture-related morbidity and mortality when compared to women (Cheng N, Green ME.. We have previously published how an interdisciplinary Bone Health Team (BHT) improves screening rates in the outpatient setting. Here we describe the results of identifying individuals for screening in the inpatient setting. METHODS: Over the course of 3 months, on 5 of 7 days per week, all patients on the inpatient medical wards of our hospital were reviewed for age-based screening eligibility (aged 70 years of over in men, aged 65 or over in women) based upon current National Osteoporosis Foundation and Endocrine Society guidelines. All individuals felt clinically appropriate for DXA and/or treatment recommendations were also earmarked for outpatient BHT follow-up. RESULTS: Of the 203 individuals identified as meeting age-based criteria, 200 (98.5%) were men and 3 (0.015%) were women, with ages ranging from 70 to 98, and with 48 (23.6%) having had dual energy x-ray absorptiometry (DXA) studies in the 2 years prior to identification (28 (58.3%) of which were performed by our outpatient program) and 13 (6.4%) with DXAs >2 years prior (range 3-11 years). Two had previously received recommendations for DXAs but had refused. Charts of all 155 (76.4% of the 203) without recent DXAs were reviewed: DXA was not felt to be clinically useful but treatment recommendations based upon fracture history were made in 7 (4.5% of the 155); 33 (21.2%) did not have DXA recommended related to goals of care; 18 (11.6%) received inpatient DXA recommendations and a post-hospital contact but declined the study; 5 (3.2%) were not local and would not have had follow-up; 4 (2.6%) did not get the recommended DXA for unclear reasons; 1 (0.6%) died during the hospitalization. Notably, of the 155 age-eligible without a DXA in the last 2 years, 87 (56.1% (42.9% of the total age-eligible)) went on to complete a DXA within the next 3 months. CONCLUSION: When compared to published rates for primary care, a dedicated inpatient BHT results in higher rates of DXA screening completion in those meeting age-based criteria.