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Journal of Osteoporosis
Volume 2016, Article ID 2937426, 6 pages
Research Article

Understanding Referral Patterns for Bone Mineral Density Testing among Family Physicians: A Qualitative Descriptive Study

1Department of Physical Therapy, University of Toronto, Toronto, ON, Canada M5G 1V7
2Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada M5G 2A2
3Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada M5B 1W8
4Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada M5T 3M6
5Department of Medicine, University of Toronto, Toronto, ON, Canada M5S 1A8
6Institute of Clinical Evaluative Sciences, Toronto, ON, Canada M4N 3M5
7Women’s College Research Institute, Toronto, ON, Canada M5S 1B2
8The Scarborough Hospital, Scarborough, ON, Canada M1P 2V5
9Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada M5G 1V7

Received 29 May 2015; Accepted 27 December 2015

Academic Editor: Anne-marie Schott

Copyright © 2016 Sarah E. P. Munce et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Evidence of inappropriate bone mineral density (BMD) testing has been identified in terms of overtesting in low risk women and undertesting among patients at high risk. In light of these phenomena, the objective of this study was to understand the referral patterns for BMD testing among Ontario’s family physicians (FPs). Methods. A qualitative descriptive approach was adopted. Twenty-two FPs took part in a semi-structured interview lasting approximately 30 minutes. An inductive thematic analysis was performed on the transcribed data in order to understand the referral patterns for BMD testing. Results. We identified a lack of clarity about screening for osteoporosis with a tendency for baseline BMD testing in healthy, postmenopausal women and a lack of clarity on the appropriate age for screening for men in particular. A lack of clarity on appropriate intervals for follow-up testing was also described. Conclusions. These findings lend support to what has been documented at the population level suggesting a tendency among FPs to refer menopausal women (at low risk). Emphasis on referral of high-risk groups as well as men and further clarification and education on the appropriate intervals for follow-up testing is warranted.