An audit of compliance with DEXA scanning for breast cancer patients treated with aromatase inhibitors
Association of Breast Surgery ePoster Library. Rashid S. 05/15/17; 166190; P086
Ms. Sameena Rashid
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Abstract
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Introduction : Aromatase inhibitors increase the risk of osteoporosis. According to SIGN guidelines all postmenopausal women should have a baseline DEXA (dual energy X-ray absorptiometry) scan within 6 months of commencing therapy. If abnormal, scans should be biennial otherwise no follow up is indicated. Our aim was to identify if these guidelines were being followed and therapy initiated at the primary care level.
Method: Electronic records of 150 consecutive patients on aromatase inhibitors across 3 sister hospitals were analyzed. All patients presented to clinic in June-August 2016 over a 3 month period.
Results: Of the 150 cases reviewed, 91% (136 patients) had baseline DEXA scans within 6 months of commencing treatment (site variation 86-98%). In addition, 53% (32/60) of patients requiring 2 yearly DEXA scans had received them in this time frame. However, 73% of patients (27/37) underwent regular scanning despite no requirement for this. All of these were normal. 130 patients (90%) had confirmed evidence on electronic records of communication with the primary care team. Of these, 109 patients (84%) had prescriptions matching treatment recommendations. 2 patients had fractures but were never DEXA scanned.
Conclusion: Despite site variation, we are close to achieving 100% DEXA scanning within the first 6 months of commencing aromatase therapy. However, adherence to guidelines for follow up scanning was poor. Our results suggest that regular scanning in those with normal bone health does not offer any benefit. Bisphosphonate compliance was the main reason for ECS scripts not matching suggested therapy.
Method: Electronic records of 150 consecutive patients on aromatase inhibitors across 3 sister hospitals were analyzed. All patients presented to clinic in June-August 2016 over a 3 month period.
Results: Of the 150 cases reviewed, 91% (136 patients) had baseline DEXA scans within 6 months of commencing treatment (site variation 86-98%). In addition, 53% (32/60) of patients requiring 2 yearly DEXA scans had received them in this time frame. However, 73% of patients (27/37) underwent regular scanning despite no requirement for this. All of these were normal. 130 patients (90%) had confirmed evidence on electronic records of communication with the primary care team. Of these, 109 patients (84%) had prescriptions matching treatment recommendations. 2 patients had fractures but were never DEXA scanned.
Conclusion: Despite site variation, we are close to achieving 100% DEXA scanning within the first 6 months of commencing aromatase therapy. However, adherence to guidelines for follow up scanning was poor. Our results suggest that regular scanning in those with normal bone health does not offer any benefit. Bisphosphonate compliance was the main reason for ECS scripts not matching suggested therapy.
Introduction : Aromatase inhibitors increase the risk of osteoporosis. According to SIGN guidelines all postmenopausal women should have a baseline DEXA (dual energy X-ray absorptiometry) scan within 6 months of commencing therapy. If abnormal, scans should be biennial otherwise no follow up is indicated. Our aim was to identify if these guidelines were being followed and therapy initiated at the primary care level.
Method: Electronic records of 150 consecutive patients on aromatase inhibitors across 3 sister hospitals were analyzed. All patients presented to clinic in June-August 2016 over a 3 month period.
Results: Of the 150 cases reviewed, 91% (136 patients) had baseline DEXA scans within 6 months of commencing treatment (site variation 86-98%). In addition, 53% (32/60) of patients requiring 2 yearly DEXA scans had received them in this time frame. However, 73% of patients (27/37) underwent regular scanning despite no requirement for this. All of these were normal. 130 patients (90%) had confirmed evidence on electronic records of communication with the primary care team. Of these, 109 patients (84%) had prescriptions matching treatment recommendations. 2 patients had fractures but were never DEXA scanned.
Conclusion: Despite site variation, we are close to achieving 100% DEXA scanning within the first 6 months of commencing aromatase therapy. However, adherence to guidelines for follow up scanning was poor. Our results suggest that regular scanning in those with normal bone health does not offer any benefit. Bisphosphonate compliance was the main reason for ECS scripts not matching suggested therapy.
Method: Electronic records of 150 consecutive patients on aromatase inhibitors across 3 sister hospitals were analyzed. All patients presented to clinic in June-August 2016 over a 3 month period.
Results: Of the 150 cases reviewed, 91% (136 patients) had baseline DEXA scans within 6 months of commencing treatment (site variation 86-98%). In addition, 53% (32/60) of patients requiring 2 yearly DEXA scans had received them in this time frame. However, 73% of patients (27/37) underwent regular scanning despite no requirement for this. All of these were normal. 130 patients (90%) had confirmed evidence on electronic records of communication with the primary care team. Of these, 109 patients (84%) had prescriptions matching treatment recommendations. 2 patients had fractures but were never DEXA scanned.
Conclusion: Despite site variation, we are close to achieving 100% DEXA scanning within the first 6 months of commencing aromatase therapy. However, adherence to guidelines for follow up scanning was poor. Our results suggest that regular scanning in those with normal bone health does not offer any benefit. Bisphosphonate compliance was the main reason for ECS scripts not matching suggested therapy.
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