Abstract | UNLABELLED: INTRODUCTION: 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.
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Authors | A Wilk, S Sajjan, A Modi, C-P S Fan, P Mavros |
Journal | Osteoporosis 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 |
PMID | 25112720
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Bone Density Conservation Agents
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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)
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