Literature DB >> 19534577

Family physicians' personal and practice characteristics that are associated with improved utilization of bone mineral density testing and osteoporosis medication prescribing.

George Ioannidis1, Alexandra Papaioannou, Lehana Thabane, Amiram Gafni, Anthony Hodsman, Brent Kvern, Aleksandra Walsh, Famida Jiwa, Jonathan D Adachi.   

Abstract

Family physicians' personal and practice characteristics may influence how osteoporosis is managed. Thus, we evaluated the impact of family physicians' personal and practice characteristics on the appropriate use of bone mineral density testing and osteoporosis therapy. The physician questionnaire assessed 13 personal and practice characteristics of the physicians. The patient questionnaire was used to collect data to ascertain how family physicians managed osteoporosis. A total of 225 family physicians from 7 provinces across Canada completed both the physician and patient questionnaires. The family physicians evaluated a total of 5601 patients. The generalized estimating equations technique was utilized to model the associations between family physicians' personal and practice characteristics and appropriate use of bone mineral density testing and osteoporosis therapy. Odds ratios (OR) and corresponding 95% confidence intervals (CI) are reported. Findings indicated that female family physicians have higher odds of administering appropriate bone density testing compared to male family physicians (OR: 1.28; 95% CI: 1.05, 1.55), and that physicians who have hospital privileges (OR: 0.77; 95% CI: 0.62, 0.97) and who graduated more recently from medical school (OR: 0.87; 95% CI: 0.77, 0.99) have lower odds of administering appropriate bone mineral density tests. Physicians who use electronic health records have higher odds of administering appropriate therapy (OR: 1.30; 95% CI: 1.06, 1.59) as compared to physicians who do not use them. Several family physicians' personal and practice characteristics are associated with appropriate utilization of bone mineral density testing and therapy. The education of both clinicians and policy makers regarding these new insights may translate to enhanced individual practices and an improved overall health care system to optimize the environment for managing osteoporosis.

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Year:  2009        PMID: 19534577      PMCID: PMC5101058          DOI: 10.1089/pop.2008.0025

Source DB:  PubMed          Journal:  Popul Health Manag        ISSN: 1942-7891            Impact factor:   2.459


  44 in total

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Authors:  D W Bates; G J Kuperman; E Rittenberg; J M Teich; J Fiskio; N Ma'luf; A Onderdonk; D Wybenga; J Winkelman; T A Brennan; A L Komaroff; M Tanasijevic
Journal:  Am J Med       Date:  1999-02       Impact factor: 4.965

2.  Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review.

Authors:  D L Hunt; R B Haynes; S E Hanna; K Smith
Journal:  JAMA       Date:  1998-10-21       Impact factor: 56.272

3.  Mortality after all major types of osteoporotic fracture in men and women: an observational study.

Authors:  J R Center; T V Nguyen; D Schneider; P N Sambrook; J A Eisman
Journal:  Lancet       Date:  1999-03-13       Impact factor: 79.321

4.  Osteoporosis follow-up after wrist fractures following minor trauma.

Authors:  S A Khan; C de Geus; B Holroyd; A S Russell
Journal:  Arch Intern Med       Date:  2001-05-28

5.  Risk factors for traumatic and bloody lumbar puncture in children with acute lymphoblastic leukemia.

Authors:  Scott C Howard; Amar J Gajjar; Cheng Cheng; Stephen B Kritchevsky; Grant W Somes; Patricia L Harrison; Raul C Ribeiro; Gaston K Rivera; Jeffrey E Rubnitz; John T Sandlund; Alberto J de Armendi; Bassem I Razzouk; Ching-Hon Pui
Journal:  JAMA       Date:  2002 Oct 23-30       Impact factor: 56.272

6.  The effect on test ordering of informing physicians of the charges for outpatient diagnostic tests.

Authors:  W M Tierney; M E Miller; C J McDonald
Journal:  N Engl J Med       Date:  1990-05-24       Impact factor: 91.245

7.  Physician gender bias in clinical decisionmaking: screening for cancer in primary care.

Authors:  P Franks; C M Clancy
Journal:  Med Care       Date:  1993-03       Impact factor: 2.983

8.  Primary care delivery is associated with greater physician experience and improved survival among persons with AIDS.

Authors:  Mari M Kitahata; Stephen E Van Rompaey; Peter W Dillingham; Thomas D Koepsell; Richard A Deyo; Wayne Dodge; Edward H Wagner
Journal:  J Gen Intern Med       Date:  2003-02       Impact factor: 5.128

9.  Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study.

Authors:  Cynthia L Leibson; Anna N A Tosteson; Sherine E Gabriel; Jeanine E Ransom; L Joseph Melton
Journal:  J Am Geriatr Soc       Date:  2002-10       Impact factor: 5.562

10.  The influence of gender on physician practice style.

Authors:  K D Bertakis; L J Helms; E J Callahan; R Azari; J A Robbins
Journal:  Med Care       Date:  1995-04       Impact factor: 2.983

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  3 in total

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Journal:  Drugs Aging       Date:  2011-09-01       Impact factor: 3.923

2.  Osteoporosis guideline awareness among Iranian family physicians: results of a knowledge, attitudes, and practices survey.

Authors:  Hamideh Mahdaviazad; Vahid Keshtkar; Mohammad Jafar Emami
Journal:  Prim Health Care Res Dev       Date:  2018-01-30       Impact factor: 1.458

3.  General practice variation in spirometry testing among patients receiving first-time prescriptions for medication targeting obstructive lung disease in Denmark: a population-based observational study.

Authors:  Mette M Koefoed; Jens Søndergaard; René dePont Christensen; Dorte E Jarbøl
Journal:  BMC Fam Pract       Date:  2013-08-07       Impact factor: 2.497

  3 in total

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