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    Predictors of treatment with osteoporosis medications after recent fragility fractures in a multinational cohort of postmenopausal women

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    Authors
    Greenspan, Susan L.
    Wyman, Allison
    Hooven, Frederick H.
    Adami, Silvano
    Gehlbach, Stephen H.
    Boonen, Steven
    LaCroix, Andrea Z.
    Lindsay, Robert
    Netelenbos, J. Coen
    Pfeilschifter, Johannes
    Silverman, Stuart
    Siris, Ethel S.
    Watts, Nelson B.
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    UMass Chan Affiliations
    Center for Outcomes Research
    Document Type
    Journal Article
    Publication Date
    2012-03-01
    Keywords
    Aged
    Chi-Square Distribution
    Female
    Follow-Up Studies
    Fractures, Bone
    Humans
    Middle Aged
    Osteoporosis, Postmenopausal
    Prospective Studies
    Questionnaires
    Regression Analysis
    Risk Factors
    Health Services Research
    Musculoskeletal Diseases
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    Link to Full Text
    http://dx.doi.org/10.1111/j.1532-5415.2011.03854.x
    Abstract
    OBJECTIVES: To determine the proportion of untreated women who reported receiving treatment after incident fracture and to identify factors that predict treatment across an international spectrum of individuals. DESIGN: Prospective observational study. Self-administered questionnaires were mailed at baseline and 1 year. SETTING: Multinational cohort of noninstitutionalized women recruited from 723 primary physician practices in 10 countries. PARTICIPANTS: Sixty thousand three hundred ninety-three postmenopausal women aged 55 and older were recruited with a 2:1 oversampling of women aged 65 and older. MEASUREMENTS: Data collected included participant demographics, medical history, fracture occurrence, medications, and risk factors for fracture. Anti-osteoporosis medications (AOMs) included estrogen, selective estrogen receptor modulators, bisphosphonates, calcitonin, parathyroid hormone, and strontium. RESULTS: After the first year of follow-up, 1,075 women reported an incident fracture. Of these, 17% had started AOM, including 15% of those with a single fracture and 35% with multiple fractures. Predictors of treatment included baseline calcium use (P = .01), baseline diagnosis of osteoporosis (P < .001), and fracture type (P < .001). In multivariable analysis, women taking calcium supplements at baseline (odds ratio (OR) = 1.67) and with a baseline diagnosis of osteoporosis (OR = 2.55) were more likely to be taking AOM. Hip fracture (OR = 2.61), spine fracture (OR = 6.61), and multiple fractures (OR = 3.79) were associated with AOM treatment. Age, global region, and use of high-risk medications were not associated with treatment. CONCLUSION: More than 80% of older women with new fractures were not treated, despite the availability of AOM. Important factors associated with treatment in this international cohort included diagnosis of osteoporosis before the incident fracture, spine fracture, and to a lesser degree, hip fracture. Geriatrics Society.
    Source
    J Am Geriatr Soc. 2012 Mar;60(3):455-61. doi: 10.1111/j.1532-5415.2011.03854.x. Epub 2012 Feb 8. Link to article on publisher's site
    DOI
    10.1111/j.1532-5415.2011.03854.x
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/27143
    PubMed ID
    22316070
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1532-5415.2011.03854.x
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