HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Post-fracture pharmacotherapy for women with osteoporotic fracture: analysis of a managed care population in the USA.

AbstractUNLABELLED:
Pharmacologic therapy is recommended to reduce future fracture risk. We examined osteoporosis medications dispensed to older women after first fracture. Only 23 % received therapy during the first year post-fracture. Prior osteoporosis therapy, a prior osteoporosis diagnosis, and older age were good predictors of post-fracture osteoporosis therapy.
INTRODUCTION:
Pharmacologic therapy is recommended after osteoporotic fracture to reduce future fracture risk. The objective of this retrospective study was to examine osteoporosis therapy dispensed to women post-fracture.
METHODS:
We identified women ≥50 years old in a large administrative claims database from 2003 to mid-2012 who were continuously enrolled 2 years before (baseline) and 1 year after first osteoporotic fracture. Exclusions were Paget's disease or malignant neoplasm. Pre- and post-fracture osteoporosis therapies (oral and parenteral) were assessed overall and by fracture site.
RESULTS:
A total of 47,171 women of mean (SD) age of 63 (10) years were eligible; fractures included 8 % hip, 17 % vertebral, 73 % non-hip/non-vertebral, and 3 % multiple fracture sites. Only 18 % received osteoporosis therapy within 90 days and 23 % within 1 year post-fracture. Overall, 19 % of women had a prior osteoporosis diagnosis; 20 % had received osteoporosis therapy during baseline. Of 37,649 (80 %) women without baseline therapy, only 9 % initiated pharmacologic therapy within 1 year. The adjusted odds ratio (OR) of therapy within 1 year post-fracture was significantly greater for women who had received baseline osteoporosis therapy (versus none) and who had vertebral (OR 12.7, 95 % confidence interval (CI) 11.2-14.5), hip (15.2, 12.5-18.7), or non-hip/non-vertebral fracture (34.4, 31.7-37.3). Other significant predictors included pre-fracture osteoporosis diagnosis (1.6, 1.4-1.7) and older age (OR range, 1.3-1.7). Treatment adherence was significantly better among women with baseline osteoporosis diagnosis.
CONCLUSIONS:
The substantial post-fracture treatment gap represents an important unmet need for women with osteoporotic fractures. Fracture liaison or adherence programs could lead to improved post-fracture treatment rates.
AuthorsA Wilk, S Sajjan, A Modi, C-P S Fan, P Mavros
JournalOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 25 Issue 12 Pg. 2777-86 (Dec 2014) ISSN: 1433-2965 [Electronic] England
PMID25112720 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Bone Density Conservation Agents
Topics
  • Aged
  • Aged, 80 and over
  • Bone Density Conservation Agents (therapeutic use)
  • Comorbidity
  • Drug Prescriptions (statistics & numerical data)
  • Drug Utilization (statistics & numerical data)
  • Female
  • Humans
  • Managed Care Programs
  • Medication Adherence (statistics & numerical data)
  • Middle Aged
  • Osteoporosis, Postmenopausal (drug therapy, epidemiology)
  • Osteoporotic Fractures (epidemiology, prevention & control)
  • Recurrence
  • Retrospective Studies
  • United States (epidemiology)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: