Enhancing Osteoporosis Screening in High-Risk Men Ages 50 Years and Older: A Clinical Decision Support and Workflow Integration Approach.

Abstract

Osteoporosis screening is well-established for women but lacks widely accepted guidelines for men, despite higher post-fracture mortality rates. This study aims to increase the proportion of men ages 50 years and older with risk factors who receive appropriate osteoporosis screening. We conducted an interventional cohort study examining men ages 50 years and older with risk factors seen at the study clinic between March 27, 2024, and June 1, 2024. Interventions included clinical decision support in the electronic medical record and integration of osteoporosis screening into the Medicare Annual Well Visit workflow. The proportion of eligible men with up-to-date osteoporosis screening increased from 11.6% (38/329) to 57.7% (239/414). Among those screened, 33.5% had normal bone density, 47.7% were diagnosed with osteopenia, and 18.8% had osteoporosis. Implementing clinical decision support, workflow changes, and provider education significantly improved osteoporosis screening rates. The high prevalence of osteopenia (47.7%) and osteoporosis (18.8%) underscores the need for routine screening in high-risk men. These findings highlight the potential for targeted interventions to enhance early detection and treatment, reducing fracture risk and improving long-term outcomes.