A captive audience: a pilot study of screening and counseling hospitalized women for fracture risk.

BACKGROUND: Innovative methods are needed to improve screening for osteoporosis, especially in women with multiple comorbid conditions. OBJECTIVES: Determine whether a fracture risk-screening program including a bedside calcaneal ultrasound is feasible in hospitalized women, and determine whether identification of fracture risks results in behavior change after discharge. DESIGN: Prospective uncontrolled feasibility study. SETTING: Five hundred twenty-eight bed academic hospital. PARTICIPANTS: One hundred three hospitalized women age 60 years or older. METHODS: A bedside calcaneal ultrasound was used to estimate bone mineral density. Clinical fracture risks were obtained via interview. The patient and primary care physician received personalized risk information and educational material. RESULTS: Of 103 eligible women, 59 (57%) agreed to undergo bedside screening and counseling. Of these 59 women, 49 (83%) had at least one major clinical risk factor for fracture. The median T-score was -2.5. Among the 42 women available for phone follow-up 2 months after hospital discharge, 34 (81%) reported after at least 1 recommendation to diminish fracture risk. CONCLUSION: A hospital-based osteoporosis screening program using calcaneal ultrasound is feasible and identifies women at risk of fracture. Feedback of low bone mineral density and fracture risk during hospitalization may promote behavior change to diminish fracture risk after discharge.