The BMD Muddle: The Disconnect Between Bone Densitometry Results and Perception of Bone Health

We conducted a phenomenological qualitative study to examine fracture patients' interpretations of their most recent bone densitometry results and perceptions of their current bone health. English-speaking outpatients who had sustained a fragility fracture in the previous 18-24 mo and reported having at least 1 previous bone mineral density (BMD) test were eligible. Data were collected through semistructured interviews in patients' homes. Patients were asked to describe their most recent BMD test results and perception of their bone health status based on these results. Eighteen patients (14 women and 4 men) aged 49-82 yr were recruited. BMD results showed bone density in patients to be normal (n = 4), osteopenic (n = 9), and osteoporotic (n = 5). A correct diagnosis was recalled by 6 patients. Two common interpretations of BMD test results emerged: (1) no news was considered to be good news (n = 9) and (2) evidence of compromised bone health was not considered to be serious or accurate (n = 6). Medication adherence did not appear to be associated with perception of bone health or actual BMD results. Patients' perceptions of their current bone health did not correspond to the results of their most recent BMD test. Standardized bone densitometry reporting may improve patients' understanding of their bone health.