P5454 - Disparity in Osteoporosis Screening in Veterans With Inflammatory Bowel Disease: A Quality Improvement Project in a Resident-Run Primary Care Clinic

Rasagnya Kota, MD¹, Lisa Fisher, MD²
1Stony Brook University Hospital, Port Jefferson, NY; 2Stony Brook University Hospital, Northport, NY

Introduction: Inflammatory Bowel Disease (IBD) affects 1.4 million people in the US and increases risk of comorbidities such as osteoporosis, skin cancer, depression, and colorectal cancer, which are preventable with adequate routine screening. Screening for osteoporosis/osteopenia is especially important given the morbidity and mortality associated with fractures. An estimated 17-41% of patients with IBD have osteoporosis/osteopenia due to the inflammatory state, use of steroids, age, and vitamin d malabsorption. The American College of Gastroenterology recommends screening postmenopausal women, men >70 years, and those with steroid use > 3 months. Our QI project examines whether there is a disparity in osteoporosis screening in our veteran IBD population who are ultimately at a greater risk for impaired bone health due to toxin exposures, prior physical trauma, and other co-morbidities like smoking.

Methods: The resident-run primary care clinic for veterans queried a list of patients with Crohn’s or Ulcerative Colitis. Chart review ascertained past/current use of steroids > 3 months and reviewed prior DEXA scan results documenting FRAX and T-scores. For those who qualified for screening and were never screened, telephone outreach was performed along with a DEXA scan that was offered.

Results: The resident-run primary care clinic panel had 29 patients with IBD of which 17 had never received osteoporosis screening. 15 out of these 17 patients qualified for screening. Telephone outreach was successful for 73% of the patients (11/15) and DEXA scans were ordered. 26% of the patients (4/15) either declined osteoporosis screening or could not be reached after several attempts. Of the 11 DEXA scans ordered, 7 showed osteoporosis or osteopenia with elevated FRAX and t-score resulting in bisphosphonate therapy initiation. The remaining DEXA scans were either normal or not completed yet.

Discussion: Overall, 58% of our veteran patients with IBD were never screened for osteoporosis. After our outreach, 73% of the patients who were overdue on screening were scheduled for DEXA scans. Of those who received their DEXA scan, 64% were found to have osteoporosis or osteopenia. Our study shows that osteoporosis screening in our veteran IBD population is often overlooked and can be addressed with adequate outreach by primary care physicians and gastroenterologists which can hopefully prevent high health care costs and poor quality of life from osteoporosis related fractures.

Disclosures:
Rasagnya Kota indicated no relevant financial relationships.
Lisa Fisher indicated no relevant financial relationships.

Rasagnya Kota, MD¹, Lisa Fisher, MD². P5454 - Disparity in Osteoporosis Screening in Veterans With Inflammatory Bowel Disease: A Quality Improvement Project in a Resident-Run Primary Care Clinic, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.