Can Pre-Visit Education on the Purpose of Bone Health Screenings Improve Visit Adherence?

Background Osteoporosis is one of the leading causes of mortality as people age, often going undetected until patients experience a fragility fracture or are screened. However, half of referred patients fail to attend their initial screening. The aim of this quality improvement project was to determine if pre-visit patient phone calls discussing the importance of osteoporosis screening could effectively improve visit adherence rates. Methods Between 1/17/2023 and 5/1/2023, standard of care (SOC cohort, n=309) was followed. Between 1/17/2024 and 5/1/2024, the new protocol (NP cohort, n=330) was initiated, with new patients called 3-7 days prior to their appointment with a script discussing the importance of screening. Groups were compared based on pre- vs. post-protocol and based on no-show status. Demographics pulled included age, ethnicity/race, sex, and marital status. Significant (p<0.05) differences in categorical variables were determined using Chi square or Fisher’s exact tests, and differences in continuous variables using rank sum. Results In the SOC cohort, 34 patients (11.0%) no-showed, and 35 patients (11.3%) cancelled. In the NP cohort, 23 patients (7.0%) no-showed, and 57 (17.3%) cancelled/rescheduled. NP cohort patients were 1.6 times more likely to cancel/reschedule than SOC cohort. Significant differences were found in age for patients who no-showed vs. those who did not (64.4 years (sd 12.6) vs. 68.2 years (sd 12.5)). Under-represented minorities were more likely to no-show (p=.005). Conclusion When patients answer their phone for a pre-visit education call prior to their bone health evaluation, no-show rates can be effectively reduced from 11% to 2.7%.