Low frequency of treatment of osteoporosis among postmenopausal women following a fracture
Meyers Primary Care Institute
Aged; Calcitonin; Diphosphonates; Drug Utilization Review; *Estrogen Replacement Therapy; Female; Fractures, Bone; Hip Fractures; Humans; Middle Aged; Osteoporosis, Postmenopausal; control; Retrospective Studies; Spinal Fractures; Wrist Injuries
Life Sciences | Medicine and Health Sciences
BACKGROUND: Osteoporosis is a major cause of morbidity. Treatment of osteoporosis reduces the risk of fracture, particularly for postmenopausal women with a history of fracture.
METHODS: A retrospective study was conducted using the automated databases of 7 health maintenance organizations to evaluate the use of drugs recommended for secondary prevention of osteoporotic fracture. Women 60 years and older with an inpatient or outpatient diagnostic code for a fracture of the hip, vertebra, or wrist between October 1, 1994, and September 30, 1996, and at least 1 year of continuous enrollment with a drug benefit plan following the date of fracture, were identified. The frequency of use of medications for the treatment of osteoporosis (estrogen replacement therapy, bisphosphonates, and calcitonin) during the 1-year period following the date of the initial fracture was estimated overall and according to patient age, fracture site, and year of fracture.
RESULTS: During the study period, 3492 women 60 years and older were diagnosed with a fracture of the hip, vertebra, or wrist, and met the inclusion criteria. Of these patients, 822 (24%) received a drug for osteoporosis treatment during the year following the fracture. The proportion of women receiving treatment for osteoporosis was approximately 2-fold higher among those with a fracture of the vertebra (44%) than among those with a fracture of the hip (21%) or wrist (23%) (P<.001). Of the 2605 women who had not been treated for osteoporosis in the 90 days before a fracture, 14% received treatment for osteoporosis in the year following a fracture. Increasing age was associated with a reduced likelihood of receiving osteoporosis treatment (P<.001).
CONCLUSIONS: Most of the older women who had experienced a fracture of the hip, vertebra, or wrist did not receive drug treatment for osteoporosis within 1 year following the fracture. Interventions to improve the detection and treatment of osteoporosis in high-risk patients need to be developed.
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Citation: Arch Intern Med. 2003 Sep 22;163(17):2052-7. Link to article on publisher's site
DOI of Published Version
Archives of internal medicine
Andrade, Susan E.; Majumdar, Sumit R.; Chan, K. Arnold; Buist, Diana S. M.; Go, Alan S.; Goodman, Michael J.; Smith, David H.; Platt, Richard; and Gurwitz, Jerry H., "Low frequency of treatment of osteoporosis among postmenopausal women following a fracture" (2003). Open Access Articles. 229.