Extensive undertreatment of osteoporosis in older Swedish women
| Autor: | Dan Mellström, Daniel Sundh, Mattias Lorentzon, Helena Johansson, John A. Kanis, Anna G Nilsson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Pediatrics Endocrinology Diabetes and Metabolism Population Osteoporosis 030209 endocrinology & metabolism Therapeutics Drug Prescriptions Risk Assessment 03 medical and health sciences 0302 clinical medicine Absorptiometry Photon Bone Density Risk Factors Internal medicine medicine Humans education Osteoporosis Postmenopausal Aged Aged 80 and over Sweden Hip fracture education.field_of_study Anthropometry Bone Density Conservation Agents business.industry Femur Neck Incidence (epidemiology) Odds ratio Bone fracture medicine.disease Rheumatology Drug Utilization Practice Guidelines as Topic Original Article Female Hip Joint 030101 anatomy & morphology Risk assessment business Osteoporotic Fractures |
| Zdroj: | Osteoporosis International |
| ISSN: | 1433-2965 0937-941X |
| Popis: | Summary In a population-based study of older Swedish women, we investigated the proportion of women treated with osteoporosis medication in relation to the proportion of women eligible for treatment according to national guidelines. We found that only a minority (22%) of those eligible for treatment were prescribed osteoporosis medication. Introduction Fracture rates increase markedly in old age and the incidence of hip fracture in Swedish women is among the highest in the world. Although effective pharmacological treatment is available, treatment rates remain low. Limited data are available regarding treatment rates in relation to fracture risk in a population-based setting in older women. Therefore, we aimed to investigate the proportion of older women eligible for treatment according to Swedish Osteoporosis Society (SvOS) guidelines. Methods A population-based study was performed in Gothenburg in 3028 older women (77.8 ± 1.6 years [mean ± SD]). Bone mineral density of the spine and hip was measured with dual-energy X-ray absorptiometry. Clinical risk factors for fracture and data regarding osteoporosis medication was collected with self-administered questionnaires. Logistic regression was used to evaluate whether the 10-year probability of sustaining a major osteoporotic fracture (FRAX-score) or its components predicted treatment with osteoporosis medication. Results For the 2983 women with complete data, 1107 (37%) women were eligible for treatment using SvOS criteria. The proportion of these women receiving treatment was 21.8%. For women eligible for treatment according to SvOS guidelines, strong predictors for receiving osteoporosis medication were glucocorticoid treatment (odds ratio (95% CI) 2.88 (1.80–4.59)) and prior fracture (2.58 (1.84–3.61)). Conclusion This study demonstrates that a substantial proportion of older Swedish women should be considered for osteoporosis medication given their high fracture risk, but that only a minority receives treatment. |
| Databáze: | OpenAIRE |
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