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

Table 1

Screening postmenopausal women in the absence of other clinical risk factors.

Interview 10	often I’m doing [BMD tests] at menopause time in a woman’s life when things sort of come up. I get a baseline maybe at menopause
Interview 13	Okay, [a referral] yesterday, a woman in for her physical. She is newly menopausal. It’s been years since her last period, 50 years old, smoker … That particular case did not have any other risk factors
Interview 20	Then occasionally [I make a referral] when women say “I need a bone density, don’t I” and they argue with me and they say their gynecologist does it and they have no reason to but I get tired of arguing
Interview 21	I try to [make referrals] based on the osteoporosis guidelines, anybody over the age of 65 male or female I order it, women who are post- menopausal and wanting to consider just a baseline bone density and other people who have other risk factors
Interview 22	I guess right now [I refer] mainly for screening postmenopausal women
What the 2010 Canadian CPGs for the diagnosis and management of osteoporosis indicate.	(i) Indications for baseline BMD testing include all women and men age ≥65
	(ii) Ordering a BMD test in women younger than 65 years of age as a baseline test because they are menopausal is not indicated in the absence of other risk factors