Anti-osteoporosis drug prescribing after hip fracture in the UK: 2000-2010
Anti-osteoporosis drug prescribing after hip fracture in the UK: 2000-2010
Summary
The probability of initiating with anti-osteoporosis therapy increased from 7 % in 2000 to 46 % in 2010. This improvement was greater for patients over the age of 75 years. Men, those overweight, having dementia or exposed to antipsychotics, sedatives/hypnotics or opioid analgesics were significantly less likely to receive anti-osteoporosis drugs.
Introduction
The objective of this study was to examine trends and determinants of anti-osteoporosis drug prescribing after hip fracture in the UK between 2000 and 2010.
Methods
Data were extracted from the UK Clinical Practice Research Datalink for patients ?50 years who had a first hip fracture between 2000 and 2010 and who did not currently (?6 months prior) receive anti-osteoporosis drugs (bisphosphonates, strontium ranelate, parathyroid hormone, calcitonin and raloxifene) (n?=?27,542). The cumulative incidence probability of being prescribed anti-osteoporosis drugs within 1 year after hip fracture was estimated by Kaplan-Meier life-table analyses. Determinants for treatment initiation were estimated by Cox proportional hazards models.
Results
The probability of being prescribed any anti-osteoporosis drug after hip fracture increased from 7 % in 2000 to 46 % in 2010. This trend was more marked in patients ?75 years. The increase in prescribing of anti-osteoporosis drugs was complemented by a similar increase in vitamin D/calcium provision. Cumulative incidence of receiving anti-osteoporosis therapy was greater at any given point in time in women (8 % in 2000, 51 % in 2010) compared to men (4 % in 2000, 34 % in 2010). In addition to male gender, multivariable Cox regression identified reduced likelihood of receiving anti-osteoporosis drugs for those being overweight, having dementia and exposed to psychotropic drugs (antipsychotics, sedatives/hypnotics) or opioid analgesics.
Conclusion
Although the prescribing of anti-osteoporosis drugs after hip fracture has increased substantially since 2000, the overall rate remained inadequate, particularly in men. With the continuing increase in the absolute number of hip fractures, further research should be made into the barriers to optimise osteoporosis management.
anti-osteoporotic drugs, bisphosphonate, osteoporosis, osteoporotic fracture
1919-1928
Klop, C.
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Gibson-Smith, D.
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Elders, P.J.
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Welsing, P.M.
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Leufkens, H.G.
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Harvey, N.C.
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Bijlsma, J.W.
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Van Staa, T.P.
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de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
July 2015
Klop, C.
fcfb681b-fb0a-4d48-9b66-35a0a3edfb66
Gibson-Smith, D.
f28f4543-4cf1-4e29-8580-0f99abb462ce
Elders, P.J.
9527261b-37be-4368-8ea1-be54835980c0
Welsing, P.M.
3f264c6d-3e5f-4a46-b468-6f36120fe7d0
Leufkens, H.G.
6f387677-0ec5-408b-bdbc-7a50d49631b6
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Bijlsma, J.W.
7cb4fea9-4b22-4ba9-8bfc-01eef45503ef
Van Staa, T.P.
31b8bfb4-4e1b-4a48-a5a6-90ca601b94af
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
Klop, C., Gibson-Smith, D., Elders, P.J., Welsing, P.M., Leufkens, H.G., Harvey, N.C., Bijlsma, J.W., Van Staa, T.P. and de Vries, F.
(2015)
Anti-osteoporosis drug prescribing after hip fracture in the UK: 2000-2010.
Osteoporosis International, 26 (7), .
(doi:10.1007/s00198-015-3098-x).
(PMID:25963232)
Abstract
Summary
The probability of initiating with anti-osteoporosis therapy increased from 7 % in 2000 to 46 % in 2010. This improvement was greater for patients over the age of 75 years. Men, those overweight, having dementia or exposed to antipsychotics, sedatives/hypnotics or opioid analgesics were significantly less likely to receive anti-osteoporosis drugs.
Introduction
The objective of this study was to examine trends and determinants of anti-osteoporosis drug prescribing after hip fracture in the UK between 2000 and 2010.
Methods
Data were extracted from the UK Clinical Practice Research Datalink for patients ?50 years who had a first hip fracture between 2000 and 2010 and who did not currently (?6 months prior) receive anti-osteoporosis drugs (bisphosphonates, strontium ranelate, parathyroid hormone, calcitonin and raloxifene) (n?=?27,542). The cumulative incidence probability of being prescribed anti-osteoporosis drugs within 1 year after hip fracture was estimated by Kaplan-Meier life-table analyses. Determinants for treatment initiation were estimated by Cox proportional hazards models.
Results
The probability of being prescribed any anti-osteoporosis drug after hip fracture increased from 7 % in 2000 to 46 % in 2010. This trend was more marked in patients ?75 years. The increase in prescribing of anti-osteoporosis drugs was complemented by a similar increase in vitamin D/calcium provision. Cumulative incidence of receiving anti-osteoporosis therapy was greater at any given point in time in women (8 % in 2000, 51 % in 2010) compared to men (4 % in 2000, 34 % in 2010). In addition to male gender, multivariable Cox regression identified reduced likelihood of receiving anti-osteoporosis drugs for those being overweight, having dementia and exposed to psychotropic drugs (antipsychotics, sedatives/hypnotics) or opioid analgesics.
Conclusion
Although the prescribing of anti-osteoporosis drugs after hip fracture has increased substantially since 2000, the overall rate remained inadequate, particularly in men. With the continuing increase in the absolute number of hip fractures, further research should be made into the barriers to optimise osteoporosis management.
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Accepted/In Press date: 12 March 2015
e-pub ahead of print date: 12 May 2015
Published date: July 2015
Keywords:
anti-osteoporotic drugs, bisphosphonate, osteoporosis, osteoporotic fracture
Organisations:
MRC Life-Course Epidemiology Unit
Identifiers
Local EPrints ID: 378392
URI: http://eprints.soton.ac.uk/id/eprint/378392
ISSN: 0937-941X
PURE UUID: 5e7dd226-4a20-4ca7-8bec-56bb5bf1ace2
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Date deposited: 01 Jul 2015 16:20
Last modified: 15 Mar 2024 03:19
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Contributors
Author:
C. Klop
Author:
D. Gibson-Smith
Author:
P.J. Elders
Author:
P.M. Welsing
Author:
H.G. Leufkens
Author:
J.W. Bijlsma
Author:
T.P. Van Staa
Author:
F. de Vries
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