Abstract
Osteoporotic fractures impose substantial morbidity and mortality among older adults. Undertreatment is an ongoing concern: treatment rates declined following reports of adverse effects of guideline-recommended bisphosphonates, but new antiresorptives have since become available. Our goal was to identify contemporary trends in osteoporosis treatment guideline adherence in a high fracture-risk population. We conducted a secondary data analysis using electronic health record data of adults aged ≥ 65 years from 68 residential aged care facilities in Australia during 2014-2017 (n =9094). Using medication administration data, we identified antiresorptive (bisphosphonates and denosumab) and vitamin D supplement use among residents with osteoporosis. Regression was used to evaluate temporal trends. and resident and facility characteristics associated with antiresorptive use and vitamin D use. In 2014, 34% of women and 42% of men with osteoporosis used antiresorptives; this decreased 8 percentage points by 2017. Antiresorptive use was higher among those with a history of fracture and lower in the last year of life. Denosumab use increased but did not substitute for the continued decline in bisphosphonate use. Vitamin D was consistently used by more than 60% of residents and was higher among those with fracture history. Greater attention to the treatment of osteoporosis treatment rates among this high fracture-risk population is warranted.
| Language | English |
|---|---|
| Pages | 1-11 |
| Number of pages | 11 |
| Journal | Health services insights |
| Volume | 12 |
| DOIs | |
| Publication status | Published - 2 Jun 2019 |
Bibliographical note
Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.Keywords
- Osteoporosis
- fracture prevention
- bisphosphonate
- denosumab
- antiresorptive
- vitamin D
- residential aged care
- long-term care
Cite this
}
Anti-osteoporosis medication use in a high fracture-risk population : contemporary trends in Australian residential aged care facilities. / Lind, Kimberly E.; Jorgensen, Mikaela L.; Gray, Leonard C.; Georgiou, Andrew; Westbrook, Johanna.
In: Health services insights, Vol. 12, 02.06.2019, p. 1-11.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Anti-osteoporosis medication use in a high fracture-risk population
T2 - Health services insights
AU - Lind,Kimberly E.
AU - Jorgensen,Mikaela L.
AU - Gray,Leonard C.
AU - Georgiou,Andrew
AU - Westbrook,Johanna
N1 - Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2019/6/2
Y1 - 2019/6/2
N2 - Osteoporotic fractures impose substantial morbidity and mortality among older adults. Undertreatment is an ongoing concern: treatment rates declined following reports of adverse effects of guideline-recommended bisphosphonates, but new antiresorptives have since become available. Our goal was to identify contemporary trends in osteoporosis treatment guideline adherence in a high fracture-risk population. We conducted a secondary data analysis using electronic health record data of adults aged ≥ 65 years from 68 residential aged care facilities in Australia during 2014-2017 (n =9094). Using medication administration data, we identified antiresorptive (bisphosphonates and denosumab) and vitamin D supplement use among residents with osteoporosis. Regression was used to evaluate temporal trends. and resident and facility characteristics associated with antiresorptive use and vitamin D use. In 2014, 34% of women and 42% of men with osteoporosis used antiresorptives; this decreased 8 percentage points by 2017. Antiresorptive use was higher among those with a history of fracture and lower in the last year of life. Denosumab use increased but did not substitute for the continued decline in bisphosphonate use. Vitamin D was consistently used by more than 60% of residents and was higher among those with fracture history. Greater attention to the treatment of osteoporosis treatment rates among this high fracture-risk population is warranted.
AB - Osteoporotic fractures impose substantial morbidity and mortality among older adults. Undertreatment is an ongoing concern: treatment rates declined following reports of adverse effects of guideline-recommended bisphosphonates, but new antiresorptives have since become available. Our goal was to identify contemporary trends in osteoporosis treatment guideline adherence in a high fracture-risk population. We conducted a secondary data analysis using electronic health record data of adults aged ≥ 65 years from 68 residential aged care facilities in Australia during 2014-2017 (n =9094). Using medication administration data, we identified antiresorptive (bisphosphonates and denosumab) and vitamin D supplement use among residents with osteoporosis. Regression was used to evaluate temporal trends. and resident and facility characteristics associated with antiresorptive use and vitamin D use. In 2014, 34% of women and 42% of men with osteoporosis used antiresorptives; this decreased 8 percentage points by 2017. Antiresorptive use was higher among those with a history of fracture and lower in the last year of life. Denosumab use increased but did not substitute for the continued decline in bisphosphonate use. Vitamin D was consistently used by more than 60% of residents and was higher among those with fracture history. Greater attention to the treatment of osteoporosis treatment rates among this high fracture-risk population is warranted.
KW - Osteoporosis
KW - fracture prevention
KW - bisphosphonate
KW - denosumab
KW - antiresorptive
KW - vitamin D
KW - residential aged care
KW - long-term care
UR - http://purl.org/au-research/grants/arc/LP120200814
U2 - 10.1177/1178632919852111
DO - 10.1177/1178632919852111
M3 - Article
VL - 12
SP - 1
EP - 11
JO - Health services insights
JF - Health services insights
SN - 1178-6329
ER -