TY - JOUR
T1 - Correlates of use of antifracture therapy in older women with low bone mineral density
AU - Ryder, Kathryn M.
AU - Shorr, Ronald I.
AU - Tylavsky, Frances A.
AU - Bush, Andrew J.
AU - Bauer, Douglas C.
AU - Simonsick, Eleanor M.
AU - Strotmeyer, Elsa S.
AU - Harris, Tamara B.
N1 - Funding Information:
Conflict of interest Financial disclosures: Dr. Ryder has received grant funding from Eli Lilly for a different study. Dr. Shorr: None Dr. Tylavsky: None Dr. Bush: None Dr. Bauer: None Dr. Simonsick: None, federal employee Dr. Strotmeyer: None Dr. Harris: None, federal employee Address correspondence and requests for reprints to Dr. Ryder: Department of Medicine, Division of General Internal Medicine, 66 N. Pauline Street, Suite 381, Memphis, TN 38163 (e-mail: kryder@utmem.edu).
Funding Information:
This work was supported by K23 RR16047 and NIA contract numbers N01-AG-6-2101; N01-AG-6-2103; N01-AG-6-2106. Author Contributions: Dr. Ryder: study concept and design, statistical analysis and interpretation, manuscript preparation Dr. Shorr: study concept and design, manuscript preparation Dr. Tylavsky: manuscript preparation Dr. Bush: statistical analysis and interpretation Dr. Bauer: study design, manuscript preparation Dr. Simonsick: manuscript preparation Dr. Strotmeyer: manuscript preparation Dr. Harris: manuscript preparation.
PY - 2006/6
Y1 - 2006/6
N2 - BACKGROUND: Guidelines exist for treatment of low bone mineral density (BMD). Little is known about patient characteristics associated with use of treatment. OBJECTIVES: To determine patient-related correlates of medication use following screening dual x-ray absorptiometry (DXA) of older adults. DESIGN: Secondary analysis of a prospective cohort study. SETTING: Pittsburgh, PA and Memphis, TN. PARTICIPANTS: Community-dwelling women between the ages 70 and 79 years enrolled in the Health, Aging, and Body Composition (Health ABC) Study. MEASUREMENTS: Risk factors for fracture and BMD of the hip were assessed at baseline. Patients and their community physicians were supplied the results of the DXA scan. Prescription and over-the-counter medication use was collected at annual exams for 2 years. RESULTS: Of 1,584 women enrolled in Health ABC, 378 had an indication for antifracture therapy and were not receiving such treatment at baseline. By the second annual follow-up examination, prescription antiresorptive medication was reported in 49 (13.0%), whereas 65 (17.2%) received calcium and/or vitamin D supplementation. In adjusted models, the strongest predictor for use of any antifracture medicine was presence of osteoporosis [vs osteopenia, odds ratio (OR), 2.9 (1.7 to 4.7)], white race [OR, 2.6 (1.5 to 4.8)], and receipt of the flu shot [OR, 2.2 (1.3 to 3.8)]. Neither a history of falls nor prior fracture was associated with use of antifracture medications. CONCLUSION: Even when physicians of study participants were provided with DXA scan results, 70% of older high-functioning women with an indication for therapy did not start or remain on an antifracture therapy. Substantial room for improvement exists in fracture prevention following a diagnosis of low BMD - especially among women with a history of falls, prior fractures, and among black women.
AB - BACKGROUND: Guidelines exist for treatment of low bone mineral density (BMD). Little is known about patient characteristics associated with use of treatment. OBJECTIVES: To determine patient-related correlates of medication use following screening dual x-ray absorptiometry (DXA) of older adults. DESIGN: Secondary analysis of a prospective cohort study. SETTING: Pittsburgh, PA and Memphis, TN. PARTICIPANTS: Community-dwelling women between the ages 70 and 79 years enrolled in the Health, Aging, and Body Composition (Health ABC) Study. MEASUREMENTS: Risk factors for fracture and BMD of the hip were assessed at baseline. Patients and their community physicians were supplied the results of the DXA scan. Prescription and over-the-counter medication use was collected at annual exams for 2 years. RESULTS: Of 1,584 women enrolled in Health ABC, 378 had an indication for antifracture therapy and were not receiving such treatment at baseline. By the second annual follow-up examination, prescription antiresorptive medication was reported in 49 (13.0%), whereas 65 (17.2%) received calcium and/or vitamin D supplementation. In adjusted models, the strongest predictor for use of any antifracture medicine was presence of osteoporosis [vs osteopenia, odds ratio (OR), 2.9 (1.7 to 4.7)], white race [OR, 2.6 (1.5 to 4.8)], and receipt of the flu shot [OR, 2.2 (1.3 to 3.8)]. Neither a history of falls nor prior fracture was associated with use of antifracture medications. CONCLUSION: Even when physicians of study participants were provided with DXA scan results, 70% of older high-functioning women with an indication for therapy did not start or remain on an antifracture therapy. Substantial room for improvement exists in fracture prevention following a diagnosis of low BMD - especially among women with a history of falls, prior fractures, and among black women.
KW - Guidelines
KW - Osteoporosis
KW - Prevention
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U2 - 10.1111/j.1525-1497.2006.00468.x
DO - 10.1111/j.1525-1497.2006.00468.x
M3 - Article
C2 - 16808749
AN - SCOPUS:33744483395
SN - 0884-8734
VL - 21
SP - 636
EP - 641
JO - Journal of general internal medicine
JF - Journal of general internal medicine
IS - 6
ER -