Patients 80 + have similar medication initiation rates to those aged 50–79 in Ontario FLS

Sale, Joanna; Yang, Alan; Elliot-Gibson, Victoria; Jain, Ravi; Sujic, R.; Linton, Denise; Weldon, J; Frankel, L.; Bogoch, Earl R.

doi:10.1007/s00198-020-05796-0

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…Our findings suggest a role for structured screening and treatment programs to avoid disparities in secondary prevention of fragility fractures between sexes and patients of varying ages. Recently, evidence presented from the Ontario Osteoporosis Strategy program suggests that standardized screening facilitates medication prescription and can eliminate sex-and agebased health inequities in secondary fracture prevention [20,56]. Ansari et al [20] demonstrated similar rates of treatment initiation between sexes with 66% of high-risk men and 68% of high-risk women (68%) started on anti-osteoporosis medications within six months of initial fracture-a prescription rate much higher than what we found (26%).…”

Section: Plos Onecontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

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Association of age, sex and race with prescription of anti-osteoporosis medications following low-energy hip fracture in a retrospective registry cohort

et al. 2022

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Background Initiation of anti-osteoporosis medications after hip fracture lowers the risk of subsequent fragility fractures. Historical biases of targeting secondary fracture prevention towards certain groups may result in treatment disparities. We examined associations of patient age, sex and race with anti-osteoporosis medication prescription following hip fracture. Methods A cohort of patients with a hip fracture between 2016–2018 was assembled from the American College of Surgeons National Surgical Quality Improvement Program registry. Patients on anti-osteoporosis medications prior to admission were excluded. Multivariable logistic regression was used to determine adjusted associations between patient age, sex and race and their interactions with prescription of anti-osteoporosis medications within 30 days of surgery. Results In total, 12,249 patients with a hip fracture were identified with a median age of 82 years (IQR: 73–87), and 67% were female (n = 8,218). Thirty days postoperatively, 26% (n = 3146) of patients had been prescribed anti-osteoporosis medication. A significant interaction between age and sex with medication prescription was observed (p = 0.04). Male patients in their 50s (OR:0.75, 95%CI:0.60–0.92), 60s (OR:0.81, 95%CI:0.70–0.94) and 70s (OR:0.89, 95%CI:0.81–0.97) were less likely to be prescribed anti-osteoporosis medication compared to female patients of the same age. Patients who belonged to minority racial groups were not less likely to receive anti-osteoporosis medications than patients of white race. Interpretation Only 26% of patients were prescribed anti-osteoporosis medications following hip fracture, despite consensus guidelines urging early initiation of secondary prevention treatments. Given that prescription varied by age and sex, strategies to prevent disparities in secondary fracture prevention are warranted.

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Section: Plos Onecontrasting

confidence: 40%

Section: Discussionmentioning

confidence: 99%

Association of age, sex and race with prescription of anti-osteoporosis medications following low-energy hip fracture in a retrospective registry cohort

et al. 2022

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“…This could also impact the chance of being prescribed osteoporotic medication. Studies have shown that FLS are effective to mitigate inequity in osteoporosis medication, benefitting men and the oldest old [ 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Secondary fracture prevention with osteoporosis medication after a fragility fracture in Sweden remains low despite new guidelines

Meyer

Sääf

et al. 2023

Arch Osteoporos

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Summary This national register study investigated osteoporosis medication prescriptions for secondary fracture prevention among older Swedish adults. Although prescription proportions are increasing for both men and women, they remain low, especially among individuals aged 90 and older. Improved Fracture Liaison Services could increase the prescription proportions and should be bolstered. Purpose Despite clear guidelines for secondary fracture prevention among older adults, it seems undertreatment persists. We aimed to describe secondary fracture prevention with medical osteoporosis treatment in the older Swedish population. Specifically, how prescription has changed over time and if these patterns differ in sociodemographic subgroups. Methods Between 2007 and 2020, osteoporosis medication use was studied among all Swedish residents aged 70 and older who had a fragility fracture in the previous 5 years. Previous fragility fractures were defined as fractures of the humerus, wrist, hip, or vertebrae. Osteoporosis medication was defined as any prescription of bone-enhancing medications (including bisphosphonates and denosumab). Results Osteoporosis medication increased over the study period, especially among men. Prescription among individuals 90 + was consistently two- to threefold lower compared to 70–79- and 80–89-year-olds. In 2018–2020, 8–17% of women and 5–9% of men, depending on age, received osteoporosis medication. At the beginning of the study period, women with higher education were more likely to be prescribed osteoporosis medication, though this difference decreased over time. Prescription of vitamin D and/or calcium as the only treatment was more common than osteoporosis medications throughout the study period. Conclusion Despite increasing prescription proportions, medical treatment for secondary fracture prevention remains low. In addition, it is more common to be prescribed vitamin D or calcium than osteoporosis medication after a fragility fracture, contrary to current guidelines. These results indicate that there is room for improvement for Fracture Liaison Services in Sweden.

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Efficiently stratifying mid-term death risk in femoral fractures in the elderly: introducing the ASAgeCoGeCC Score

et al. 2021

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Patients 80 + have similar medication initiation rates to those aged 50–79 in Ontario FLS

Cited by 6 publications

References 40 publications

Association of age, sex and race with prescription of anti-osteoporosis medications following low-energy hip fracture in a retrospective registry cohort

Association of age, sex and race with prescription of anti-osteoporosis medications following low-energy hip fracture in a retrospective registry cohort

Secondary fracture prevention with osteoporosis medication after a fragility fracture in Sweden remains low despite new guidelines

Efficiently stratifying mid-term death risk in femoral fractures in the elderly: introducing the ASAgeCoGeCC Score

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