Prevalence and predictors of osteoporosis treatment in nursing home residents with known osteoporosis or recent fracture
Authors
Colon-Emeric, Cathleen S.Lyles, Kenneth W.
Levine, Deborah
House, Paul
Schenck, Anna P.
Gorospe, Joel
Fermazin, Mary
Oliver, Kristi
Allison, Jeroan J.
Weisman, N.
Xie, A.
Curtis, Jeffrey R.
Saag, Kenneth G.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2006-11-23Keywords
AgedAged, 80 and over
Arizona
Bone Density Conservation Agents
Calcitonin
Calcium, Dietary
California
Diphosphonates
Female
Fractures, Bone
Hip
Humans
Male
Middle Aged
*Nursing Homes
Osteoporosis
Osteoporosis, Postmenopausal
Prevalence
Protective Devices
Quality of Health Care
Treatment Outcome
Vitamin D
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
Summary: We studied nursing home residents with osteoporosis or recent fracture to determine the frequency and predictors of osteoporosis treatment. There was wide variation in performance, and both clinical and systems variables predicted use. This study shows that improvement in osteoporosis care is possible and important for many nursing homes. INTRODUCTION: We determined the prevalence and predictors of osteoporosis evaluation and treatment in high-risk nursing home residents. METHODS: We identified 67 nursing facilities in North Carolina and Arizona with > 10 residents with osteoporosis or recent hip fracture. Medical records (n=895) were abstracted for osteoporosis evaluation [dual-energy X-ray absorptiometry (DXA), vitamin D level, serum calcium), treatment (calcium, vitamin D, osteoporosis medication, hip protectors), clinical, and systems covariates. Data were analyzed at the facility level using mixed models to account for the complex nesting of residents within providers and nursing facilities. RESULTS: Calcium and vitamin D was prescribed for 69% of residents, bisphosphonates for 19%, calcitonin for 14%, other pharmacologic therapies for 6%, and hip protectors for 2%. Overall, 36% received any bone protection (medication or hip protectors), with wide variation among facilities (0-85%). Factors significantly associated with any bone protection included female gender [odds ratio (OR) 2.4, (1.5-3.7)] and nonurban/suburban location [1.5, (1.1-2.2)]. Residents with esophagitis, peptic ulcer disease (PUD), or dysphagia [0.6, (0.4-0.9)] and alcohol abuse [0.2, (0.0-0.9)] were less likely to receive treatment. CONCLUSIONS: There is substantial variation in the quality of osteoporosis treatment across nursing homes. Interventions that improve osteoporosis quality of care are needed.Source
Osteoporos Int. 2007 Apr;18(4):553-9. Epub 2006 Nov 21. Link to article on publisher's siteDOI
10.1007/s00198-006-0260-5Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47685PubMed ID
17120179Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1007/s00198-006-0260-5