#2-08E. Revolutionizing Primary Osteoporosis Prevention: Remote BHS for High-Risk Men (JAMAIM, 2025)

How can clinicians effectively close the persistent gap in osteoporosis screening and treatment among high-risk older men who have not yet sustained a fracture? This cluster randomized clinical trial, involving 3,112 male veterans with fracture risk factors, evaluated the impact of a centralized, remote Bone Health Service (BHS) compared to usual care. The BHS model utilized a nurse care manager to coordinate screening via DXA, patient education, and adherence monitoring. The study revealed a dramatic increase in screening rates in the BHS group (49.2% vs 2.3%) and demonstrated exceptional medication adherence (mean 91.7%), strongly supporting the feasibility of a centralized, risk-factor-based primary prevention model. This approach provides an efficient strategy for managing bone health proactively. However, it is important to critically note that the study population was exclusively male veterans within the VA system, which may limit the external generalizability of these results to broader clinical settings8. Nonetheless, this model offers practitioners a low-cost, scalable framework to improve the initiation and persistence of crucial prophylactic osteoporosis care.

Citation: Colón-Emeric C, Lee R, Lyles KW, Zullig LL, Sloane R, Pieper CF, Nelson RE, Adler RA. Remote Bone Health Service for Osteoporosis Screening in High-Risk Men A Cluster Randomized Clinical Trial. JAMA Internal Medicine. 2025. DOI: 10.1001/jamainternmed.2025.4150

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