Akademik Veri Yönetim Sistemi
TURKIYE KLINIKLERI TIP BILIMLERI DERGISI, cilt.28, sa.1, ss.18-23, 2008 (SCI-Expanded)
Objective: To assess how Turkish physicians of different specialties manage osteoporosis and to estimate the economic costs of testing and treatment choices. Material and Methods: Two-hundred Turkish women completed a questionnaire on risk factors for osteoporosis and the number of bone mineral densitometry (BMD) evaluations performed up to date. The indications for BMD were re-evaluated according to the clinical practice guidelines of the National Osteoporosis Foundation (NOF) and the Osteoporosis Society of Canada (OSC), and the Osteoporosis Risk Assessment Instrument (ORAI) scoring system. Results: For 65 (32.5%) out of 200 patients, the results from all 3 assessment modes indicated BMD was necessary. In 54 (27%) participants, an 3 guidelines indicated that BMD was unnecessary. Postmenopausal status was the primary indication for ordering BMD. When the different reasons for recommending BMD were analyzed according to clinicians' specialties, a very large proportion of gynecologists, as well as many internists and physiatrists were found to order BMD only because the patient was postmenopausal. However, rheumatologists and endocrinologists considered additional risk factors. The patients had undergo a total of 579 BMD procedures. One hundred-one (50.5%) had been prescribed anti-resorptive therapy, however 32 (31.7%) of those individuals did not actually need the treatment. The cost of unnecessary BMD was 19 900 New Turkish Lira (YTL) (approximately $US 14 700). Furthermore, the annual cost of unnecessary treatment was 65 400 YTL (approximately $US 48 300). Conclusion: Reasons for recommending BMD and the treatment choices for osteoporosis vary among different medical specialties. The cost of unnecessary BMD testing and treatment is very high.