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Trends in oral anti-osteoporosis drug prescription in the United Kingdom between 1990 and 2012: variation by age, sex, geographic location and ethnicity

Trends in oral anti-osteoporosis drug prescription in the United Kingdom between 1990 and 2012: variation by age, sex, geographic location and ethnicity
Trends in oral anti-osteoporosis drug prescription in the United Kingdom between 1990 and 2012: variation by age, sex, geographic location and ethnicity
Introduction: Given the expected increase in the number of patients with osteoporosis and fragility fractures it is important to have concise information on trends in prescription rates of anti-osteoporosis drugs (AOD).

Methods: We undertook a retrospective observational study using the UK Clinical Practice Research Datalink (CPRD) in the UK between 1990 and 2012 in subjects 50 years or older, stratified by age, sex, geographic region and ethnicity. Yearly prescription incidence rates of any AOD and of each specific AOD were calculated as the number of patients first prescribed these AODs per 10,000 person-years (py).

Results: In women, yearly rates of first prescription of any AOD increased from 1990 to 2006 (from 2.3 to 169.7 per 10,000 py), followed by a plateau and a 12% decrease in the last three years. In men, a less steep increase from 1990 to 2007 (from 1.4 to 45.3 per 10,000 py) was followed by a plateau from 2008 onwards. Yearly rates of first prescription of any AOD increased up to the age of 85–89 years (248.9 per 10,000 py in women and 119.3 in men). There were marked differences between ethnic groups and regions. Bisphosphonates were the most frequently prescribed AODs: etidronate till 2000, and then subsequently alendronate.

Conclusion: We have demonstrated marked secular changes in rates of anti-osteoporosis drug prescription over the last two decades. The plateau (and decrease amongst women) in rates in recent years, set against an ever ageing population is worrying, suggesting that the well-documented care gap in osteoporosis treatment persists. The differences in prescription rates by geographic location and ethnicity raise intriguing questions in relation to underlying fracture rates, provision of care and health behaviour.

Summary: We studied the prescription incidence of anti-osteoporosis drugs (AOD) from 1990 to 2012 in the UK CPRD. Overall AOD prescription incidence showed a strong increase from 1990 to 2006, followed by a plateau in both sexes and a decrease amongst women in the last three years.
8756-3282
1-21
van der Velde, R.Y.
fb7773ca-97e5-4650-994f-f98825c9c7cd
Wyers, C.E.
3fe3e040-7070-476b-a0f1-bb4cac288886
Tesselink, E.
1cf70bf4-3baa-4843-a692-4fa1dd5ab708
Geusens, P.P.M.M.
283a5cbd-bd2c-4a19-8549-24f24b3bf0ad
van den Bergh, J.P.W.
c30fc1ae-c65a-4c7e-a71f-cfd251a8b8b5
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
van Staa, T.P.
31b8bfb4-4e1b-4a48-a5a6-90ca601b94af
van der Velde, R.Y.
fb7773ca-97e5-4650-994f-f98825c9c7cd
Wyers, C.E.
3fe3e040-7070-476b-a0f1-bb4cac288886
Tesselink, E.
1cf70bf4-3baa-4843-a692-4fa1dd5ab708
Geusens, P.P.M.M.
283a5cbd-bd2c-4a19-8549-24f24b3bf0ad
van den Bergh, J.P.W.
c30fc1ae-c65a-4c7e-a71f-cfd251a8b8b5
de Vries, F.
db4c0543-d6e7-476b-a10e-52d9d483f613
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
van Staa, T.P.
31b8bfb4-4e1b-4a48-a5a6-90ca601b94af

van der Velde, R.Y., Wyers, C.E., Tesselink, E., Geusens, P.P.M.M., van den Bergh, J.P.W., de Vries, F., Cooper, C., Harvey, N.C. and van Staa, T.P. (2016) Trends in oral anti-osteoporosis drug prescription in the United Kingdom between 1990 and 2012: variation by age, sex, geographic location and ethnicity. Bone, 1-21. (doi:10.1016/j.bone.2016.10.013).

Record type: Article

Abstract

Introduction: Given the expected increase in the number of patients with osteoporosis and fragility fractures it is important to have concise information on trends in prescription rates of anti-osteoporosis drugs (AOD).

Methods: We undertook a retrospective observational study using the UK Clinical Practice Research Datalink (CPRD) in the UK between 1990 and 2012 in subjects 50 years or older, stratified by age, sex, geographic region and ethnicity. Yearly prescription incidence rates of any AOD and of each specific AOD were calculated as the number of patients first prescribed these AODs per 10,000 person-years (py).

Results: In women, yearly rates of first prescription of any AOD increased from 1990 to 2006 (from 2.3 to 169.7 per 10,000 py), followed by a plateau and a 12% decrease in the last three years. In men, a less steep increase from 1990 to 2007 (from 1.4 to 45.3 per 10,000 py) was followed by a plateau from 2008 onwards. Yearly rates of first prescription of any AOD increased up to the age of 85–89 years (248.9 per 10,000 py in women and 119.3 in men). There were marked differences between ethnic groups and regions. Bisphosphonates were the most frequently prescribed AODs: etidronate till 2000, and then subsequently alendronate.

Conclusion: We have demonstrated marked secular changes in rates of anti-osteoporosis drug prescription over the last two decades. The plateau (and decrease amongst women) in rates in recent years, set against an ever ageing population is worrying, suggesting that the well-documented care gap in osteoporosis treatment persists. The differences in prescription rates by geographic location and ethnicity raise intriguing questions in relation to underlying fracture rates, provision of care and health behaviour.

Summary: We studied the prescription incidence of anti-osteoporosis drugs (AOD) from 1990 to 2012 in the UK CPRD. Overall AOD prescription incidence showed a strong increase from 1990 to 2006, followed by a plateau in both sexes and a decrease amongst women in the last three years.

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Accepted/In Press date: 10 October 2016
e-pub ahead of print date: 11 October 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 401578
URI: http://eprints.soton.ac.uk/id/eprint/401578
ISSN: 8756-3282
PURE UUID: 399c338c-aa28-4a51-b7bf-79467de6e480
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for N.C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512

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Date deposited: 18 Oct 2016 13:59
Last modified: 07 Oct 2020 05:44

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Contributors

Author: R.Y. van der Velde
Author: C.E. Wyers
Author: E. Tesselink
Author: P.P.M.M. Geusens
Author: J.P.W. van den Bergh
Author: F. de Vries
Author: C. Cooper ORCID iD
Author: N.C. Harvey ORCID iD
Author: T.P. van Staa

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