In a sample of older adults, overuse of osteoporosis pharmacotherapy was only 8.1%, according to a recent study. Nevertheless, overtreatment exposes patients to possible risk with negligible chance of benefit and should be minimized. The Patient Activation After DXA Receipt Notification (PAADRN) trial aimed to quantify and identify risk factors associated with osteoporosis overtreatment. Included were patients aged ≥50 years presenting for bone density testing at 3 US healthcare systems. Researchers assessed 20,397 patients for eligibility and randomized 7,749. Intervention patients received a letter containing their dual-energy X-ray absorptiometry (DXA) results and an educational osteoporosis brochure. Control patients received usual care. Using the National Osteoporosis Foundation treatment guidelines, they defined overtreatment as the receipt of osteoporosis pharmacotherapy 12 weeks after DXA when treatment was not indicated. They found:

• Among 3,602 patients with no apparent indication for osteoporosis treatment, 292 (8.1%) received a new prescription for osteoporosis pharmacotherapy or were instructed to continue an existing medication (presumed overtreatment).
• Presumed overtreatment was more common among participants with prior DXA history, those who reported a history of osteoporosis or low bone mass, and those referred for testing by family medicine providers.