Randomized Trial of Osteoporosis Screening: Use of Hormone Replacement Therapy and Quality-of-Life Results

doi:10.1001/archinte.1997.00440390121015

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Vol. 157 No. 18, 13 OCTOBER 1997

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Randomized Trial of Osteoporosis Screening

Use of Hormone Replacement Therapy and Quality-of-Life Results

David J. Torgerson, PhD; Ruth E. Thomas; Marion K. Campbell, MSc; David M. Reid, FRCP(Edin)

Arch Intern Med. 1997;157(18):2121-2125.

Abstract

Background
Screening perimenopausal women for low bone density has yetto be tested in a randomized trial. The effect of screeningon the use of hormone replacement therapy (HRT) and the subsequentquality of life in these women is unknown. The purpose of thisstudy was to assess the effect of a screening program on HRTuse and quality of life.

Methods
A random sample of women aged 45 to 54 years and living within32 km of Aberdeen, Scotland, was selected from the communityhealth index. Subjects were further randomized to screeningor no screening using the design of Zelen. Two years after randomization,a questionnaire follow-up was mailed to both groups to assessHRT use and quality-of-life scores.

Results
Use of HRT was higher in the screened group (30% vs 24%; difference,6%; 95% confidence interval, 1%-11%; P=.02). A multivariateanalysis indicated that the odds of using HRT for a screenedwoman whose measurement for bone mineral density was in thelowest quartile was 2.54 (95% confidence interval, 1.74-3.71)greater than that of an unscreened woman. Screening and subsequentHRT use did not have any detectable effects— positiveor adverse—on women's quality of life.

Conclusion
Screening for low bone density significantly increases the useof HRT in this population but without any immediate adverseor positive effects on quality of life.

Arch Intern Med. 1997;157:2121-2125

Author Affiliations

From the National Primary Care Research and Development Centre, Centre for Health Economics, University of York, York, England (Dr Torgerson), and the Health Services Research Unit (Mss Thomas and Campbell) and Department of Medicine and Therapeutics (Dr Reid), University of Aberdeen, Aberdeen, Scotland.

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