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Study highlights need for adherence to post-fracture guidelines
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While the prevention of primary fragility fractures remains the ideal, recent study results showed the prevention of secondary fractures is critical and indicates a need to reverse the downward trend in adherence to post-fracture guidelines.
Using data from a large commercially insured population seen in the period from 2001 through 2009, researchers evaluated rates of diagnostic testing and pharmacotherapy for osteoporosis among patients 50 years or older who had a new low-energy fracture at the hip, vertebra, wrist or humerus with no evidence of a fragility fracture, osteoporosis treatment, malignant disease or Paget disease for 12 months preceding the fracture. Researchers also evaluated patients treated with oral bisphosphonates to determine whether 12 months adherence to the treatment protocol differed between those who had initiated therapy sooner and those who initiated it later following the fracture.
Study results showed 19% of the women and 10% of the men initiated osteoporosis pharmacotherapy and 30% of the women and 15% of the men underwent diagnostic testing or pharmacotherapy following fracture. While treatment rates were lowest following wrist or humeral fracture, they were highest following vertebral fracture, according to study results. Researchers found treatment rates significantly decreased over time, with the average 12 month adherence was 56% among women and 61% among men. Overall, adherence was similar between patients who had initiated treatment sooner after the fracture and patients who had initiated it later after the fracture.
“The medical community is increasingly recognizing the urgent need for fracture prevention among our elderly population,” the researchers wrote in their conclusion. “While primary fracture prevention remains ideal, secondary prevention is critical. As the ‘oldest old’ are the fastest growing segment of the U.S. population, there is a genuine need to reverse the current downward trend in adherence to post-fracture guidelines.”
Disclosures: Balasubramanian, O’Malley and Ho are employed by and have stock options in Amgen. Lane is a board member for BioMimetics, Bone Therapeutics, CollPant, Grafty’s and Zimmer; is a consultant for CollPant and D’Fine; and received payment for lectures from Eli Lilly, Warner Chilcott and Amgen. Dirschl is a consultant for Stryker Orthopaedics, Amgen and Affinergy and received royalties from Biomet. Tosi received travel payment from the Medical Society of the District of Columbia.
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