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Rates of osteoporosis treatment after hip fracture on the decline
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The majority of patients with hip fracture do not receive osteoporosis treatment and the rates of treatment have been declining, a finding that is not consistent with osteoporosis treatment guidelines endorsed by the National Osteoporosis Foundation, according to a recently published study.
“Most patients suffering a hip fracture do not use osteoporosis medication in the subsequent year and treatment rates have worsened, Daniel H. Solomon, MD, MPH, from Brigham and Women's Hospital, and colleagues, stated in the abstract.
Researchers conducted a retrospective, observational cohort study based on U.S. administrative insurance claims data for beneficiaries with commercial of Medicare supplemental health insurance. The study included 96,887 participants who were hospitalized for a hip fracture between Jan. 1, 2002, and Dec. 31, 2011, and aged 50 years or older at admission. Outcome of interest included osteoporosis medication use within 12 months after discharge. Researchers censored patients after 12 months, loss to follow-up or a medical claim for cancer or Paget’s disease, whichever event occurred first.
Overall, 35.5% of patients were censored before reaching 12 months of follow-up. Researchers found a 28.5% probability of osteoporosis medication use within 12 months after discharge as estimated by Kaplan-Meier. The rates declined from 40.2% in 2002 to 20.5% in 2011. Patient characteristics, including older age and male gender, were associated with reduced likelihood of osteoporosis medication use. However, researchers found osteoporosis medication use before the fracture was most strongly and most positively associated with the use of osteoporosis medication after fracture.
Reference:
Solomon DH. J Bone Miner Res. 2014;doi:10.1002/jbmr.2202.
Disclosure: Solomon received salary support from research grants to Brigham and Women’s Hospital from Amgen and Lilly, received honorarium from the American Orthopaedic Association’s Own the Bone Program and serves in an unpaid role on the National Bone Health Alliance.