Pharmaceutical treatment of symptomatic vertebral fractures in primary care

Torgerson, D.J., Sykes, D., Puffer, S., Brown, P. and Cooper, C. (2004) Pharmaceutical treatment of symptomatic vertebral fractures in primary care. Annals of the Rheumatic Diseases, 63 (7), 853-856. (doi:10.1136/ard.2003.013508).

Abstract

Background: Vertebral fractures are associated with a reduction in quality of life and are an important predictor of other non-spine fractures. Previous work has shown that up to 60% of patients with a vertebral fracture identified in primary care remain untreated.
Objective: To examine the prevalence of pharmaceutical treatment and predictors of treatment in a primary care setting.
Methods: Case–control study using the general practice research database (GPRD). All women aged 50 years and over with a first diagnosis of a vertebral fracture since 1990 were identified and matched with a control by age and practice. Appropriate use of a pharmaceutical agent was defined as a prescription occurring within 30 days of the diagnosis being recorded.
Results: We identified 2719 women with the same number of controls. Within 30 days of diagnosis 61% of women were prescribed treatment, compared with only 3% of the controls. Bisphosphonate was the single most important treatment prescribed. Predictors of any drug treatment included: year of fracture (most recent year increased the likelihood of treatment); age (younger patients were more likely to receive treatment); history of back pain; low body weight; history of steroid use.
Conclusions: Treatment of diagnosed vertebral fractures is becoming more common. Treated patients tend to be younger but to have a higher prevalence of clinical risk factors than untreated patients. There remain significant numbers of patients who are not offered treatment.

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Contributors

Author: C. Cooper

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