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.
Original language | English |
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Pages (from-to) | 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