Bone health screening, education, and referral project in northwest Iowa: creating a model for community pharmacies.

Objective: To identify women 60 years of age or older at risk for osteoporosis, provide education, and refer at-risk women to physicians through a community pharmacy screening program and to develop a model in community pharmacies for this service.

Design: Cross-sectional study.

Setting: Northwest Iowa between August 2005 and October 2005.

Participants: 159 women 60 years of age or older screened at five pharmacies.

Interventions: Five pharmacies completed education on osteoporosis, received training on use of the Achilles InSight by GE Lunar, and screened women 60 years of age or older for osteoporosis. Patients received education on osteoporosis and risk factors during the screening and were stratified as low, moderate, or high risk based on a T-score. Patients at risk were referred to their physician for further evaluation. Pharmacists telephoned patients at 3 and 6 months after screening to determine self-initiated or provider-initiated changes in their treatment plan.

Main Outcome Measures: Descriptive population characteristics, proportion of participants with medical risk factors for osteoporosis, proportion of patients screened at risk, and proportion of physician or patient self-initiated changes instituted as a result of the screening.

Results: Of the 159 women screened, 53% were rated as moderate or severe risk and referred to their physicians. Three- and 6-month follow-up results revealed a high proportion of self-initiated lifestyle or medication changes and a small proportion of physician-initiated changes.

Conclusion: The majority of women 60 years of age or older who attended a community pharmacy osteoporosis screening were at moderate or high risk for osteoporosis. A fee-for-service model was created for community pharmacists to improve recognition and treatment of patients at risk. A toolkit will be created for pharmacists to promote their role in improving the bone health of older patients.