Work

Response Letter to Herbert L. Muncie, Jr.

Year: 2014

Type: article

Abstract: We thank Dr. Muncie for identifying the need for clarification of the quality measure: “Osteoporosis Management in Women Who Had a Fracture.”1 The National Committee for Quality Assurance (NCQA) and the National Quality Forum (NQF) endorse this measure. Although the article stated that the measure assesses “receipt of appropriate bone density testing and pharmacotherapy within 6 months of a fragility fracture for women aged 67 and older,” we agree that this phrasing is not consistent with the official measure wording. An “or” should replace the “and” in the sentence describing the quality measure. The phrase “and” was not meant to suggest that both were recommended but that receipt of bone density testing and pharmacotherapy after a fracture were each assessed in this quality metric. The primary outcome for this study was the receipt of bone density testing or prescription pharmacotherapy within 6 months after fracture,2 which is consistent with the NCQA/NQF quality metric. Therefore this clarification of quality measure wording does not change the care measured, the findings, or the conclusion drawn in this study. We appreciate the importance of providing cost-sensitive care and avoiding unnecessary care, but the study shows that an overwhelming majority of participants received neither a bone density test nor a prescription for pharmacotherapy after a fracture. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Stephen Liu has received training grant funding from the Department of Health and Human Services, the University of Colorado, and the Hartford Foundation for projects not related to this study or paper. Stephen Liu is a consultant for the Oak Group, which produces the Managed Care Appropriateness Program Clinical Review Criteria. This consultant work was not related to the design, methods, analysis, or preparation of this paper. This work was funded through National Institutes on Aging Grants K23AG035030 (Morden) and P01 AG019783, the Robert Wood Johnson Foundation Dartmouth Atlas Project, and National Institute of Arthritis and Musculoskeletal and Skin Diseases Grant P60AR062799. Author Contributions: All authors participated in study concept and design, data analysis, interpretation of data, and preparation of manuscript. Sponsor's Role: The grant sponsors had no input on the design, methods, analysis, or preparation of this paper.

Source: Journal of the American Geriatrics Society

DOI: 10.1111/jgs.12818