Anti-osteoporosis medication use in a high fracture-risk population: contemporary trends in Australian residential aged care facilities

Research output: Contribution to journalArticleResearchpeer-review

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.

LanguageEnglish
Pages1-11
Number of pages11
JournalHealth services insights
Volume12
DOIs
Publication statusPublished - 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

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title = "Anti-osteoporosis medication use in a high fracture-risk population: contemporary trends in Australian residential aged care facilities",
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.",
keywords = "Osteoporosis, fracture prevention, bisphosphonate, denosumab, antiresorptive, vitamin D, residential aged care, long-term care",
author = "Lind, {Kimberly E.} and Jorgensen, {Mikaela L.} and Gray, {Leonard C.} and Andrew Georgiou and Johanna Westbrook",
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.",
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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.

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KW - fracture prevention

KW - bisphosphonate

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KW - vitamin D

KW - residential aged care

KW - long-term care

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