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A population-based analysis of the post-fracture care gap 1996-2008: the situation is not improving.
- Source :
-
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2012 May; Vol. 23 (5), pp. 1623-9. Date of Electronic Publication: 2011 Apr 08. - Publication Year :
- 2012
-
Abstract
- Unlabelled: The post-fracture care gap has not narrowed in recent years. Following an initial improvement, rates of medication initiation have actually declined.<br />Introduction: The current study characterizes temporal changes in post-fracture bone mineral density (BMD) testing or osteoporosis treatment initiation from 1996/1997 to 2007/2008.<br />Methods: A population-based administrative data repository for Manitoba, Canada was accessed to identify non-traumatic fractures in individuals aged 50 years and older. Outcomes included BMD testing or dispensation of an osteoporosis medication in the 12 months following the fracture.<br />Results: Thirty thousand nine hundred and twenty (30,920) fracture events met the inclusion criteria; 15,670 affected major osteoporotic fracture sites. Based on either BMD testing or treatment initiation, intervention rates reached a maximum of only 15.5% in 2003/2004, compared with 6.3% in 1996/1997, and 13.2% in 2007/2008 (p-for-trend < 0.001). Post-fracture BMD testing increased from 0.7% in 1996/1997 to 8.9% 2007/2008 (p-for-trend < 0.001). Osteoporosis medication use increased from 6.1% in 1996/1997 to 12.3% in 2001/2002 and then progressively declined to 5.9% by 2007/2008 (p-for-trend = 0.025). Similar trends were observed when only major osteoporotic fractures were included. The initiation of BMD testing or medication varied according to age, gender, geographic region, and income.<br />Conclusion: Despite increased attention to gaps in osteoporosis management post-fracture in the last 10 years, the situation has not improved: in 2007/20008, fewer than 20% of untreated individuals with a low-trauma fracture received intervention. Novel strategies are required to disseminate and implement best practices at the point of care to reduce the risk of recurrent fractures.
- Subjects :
- Absorptiometry, Photon statistics & numerical data
Age Factors
Aged
Bone Density physiology
Cohort Studies
Delivery of Health Care standards
Delivery of Health Care statistics & numerical data
Drug Utilization statistics & numerical data
Drug Utilization trends
Female
Humans
Male
Manitoba epidemiology
Middle Aged
Osteoporosis drug therapy
Osteoporosis epidemiology
Osteoporosis physiopathology
Osteoporotic Fractures epidemiology
Osteoporotic Fractures physiopathology
Retrospective Studies
Secondary Prevention
Sex Factors
Bone Density Conservation Agents therapeutic use
Delivery of Health Care trends
Disease Management
Osteoporosis diagnosis
Osteoporotic Fractures prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1433-2965
- Volume :
- 23
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
- Publication Type :
- Academic Journal
- Accession number :
- 21476038
- Full Text :
- https://doi.org/10.1007/s00198-011-1630-1