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The treatment gap after major osteoporotic fractures in Denmark 2005-2014: a combined analysis including both prescription-based and hospital-administered anti-osteoporosis medications

The treatment gap after major osteoporotic fractures in Denmark 2005-2014: a combined analysis including both prescription-based and hospital-administered anti-osteoporosis medications
The treatment gap after major osteoporotic fractures in Denmark 2005-2014: a combined analysis including both prescription-based and hospital-administered anti-osteoporosis medications

Summary: This study demonstrates a substantial and persistent anti-osteoporosis treatment gap in men and women ≥50 years old who sustained major osteoporotic fracture(s) between 2005 and 2014 in Denmark. This was not substantially reduced by including hospital-administered anti-osteoporosis treatments. Strengthened post-fracture organization of care and secondary fracture prevention is highly needed. Introduction: The purpose of this study was to evaluate the Danish anti-osteoporosis treatment gap from 2005 to 2014 in patients sustaining a major osteoporotic fracture (MOF), and to assess the impact of including hospital-administered anti-osteoporosis medications (AOM) on the treatment gap among these patients. Methods: In this retrospective, registry-based study, we included men and women aged 50 years or older and living in Denmark, who sustained at least one MOF between 2005 and 2014. We applied a repeated cross-sectional design to generate cohorts of patients sustaining a first MOF, hip, vertebral, humerus, or forearm fracture, respectively, within each calendar year. We evaluated the treatment gap as the proportion of patients within each cohort not receiving treatment with AOM within 1 year of the fracture. Hospital-administered AOM was identified by SKS code. Results: The treatment gap among MOF patients decreased from 85% in 2005 to 79% in 2014. The gap was smaller among hip and vertebral fracture patients as compared to humerus and forearm fracture patients, and it was smaller in women than in men. The use of hospital-administered AOM was relatively uncommon, with a maximum of 0.9% of MOF patients initiating hospital-administered AOM (in 2012). We observed substantial variations in this proportion between fracture types and gender. Hospital-administered AOM was most commonly used among vertebral fracture patients. Conclusion: A significant treatment gap among patients sustaining a major osteoporotic fracture was present throughout our analysis, and including hospital-administered AOM did not significantly improve the treatment gap assessment. Improved secondary fracture prevention is urgently needed.

Bisphosphonate, Fracture, Fracture prevention, Osteoporosis, Osteoporosis treatment
0937-941X
1961-1971
Skjodt, M.K.
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Ernst, M.
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Khalid, Sara
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Libanati, Cesar
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Cooper, Cyrus
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Delmestri, Antonella
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Rubin, Katrine Hass
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Kassim Javaid, M.
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Martínez-Laguna, Daniel
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Toth, Emese
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Prieto-Alhambra, Daniel
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Abrahamsen, Bo
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Skjodt, M.K.
c57ef821-0d62-4d91-909b-4f32a9f9299d
Ernst, M.
577e5b64-aa72-47d1-8093-7b1f9a27dc76
Khalid, Sara
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Libanati, Cesar
4e3b711d-453b-4f15-b175-3975d566b9c9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Delmestri, Antonella
d6087fde-5a65-41de-9b5e-bcefc4379ceb
Rubin, Katrine Hass
a582f4b8-fcd8-4801-ab3d-bc4ed4e47bfb
Kassim Javaid, M.
12781b29-34fa-4158-837b-daf452b8d4ed
Martínez-Laguna, Daniel
330a147f-0b3a-41ff-8550-3dae76ac8ab2
Toth, Emese
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Prieto-Alhambra, Daniel
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Abrahamsen, Bo
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Skjodt, M.K., Ernst, M., Khalid, Sara, Libanati, Cesar, Cooper, Cyrus, Delmestri, Antonella, Rubin, Katrine Hass, Kassim Javaid, M., Martínez-Laguna, Daniel, Toth, Emese, Prieto-Alhambra, Daniel and Abrahamsen, Bo (2021) The treatment gap after major osteoporotic fractures in Denmark 2005-2014: a combined analysis including both prescription-based and hospital-administered anti-osteoporosis medications. Osteoporosis International, 32 (10), 1961-1971. (doi:10.1007/s00198-021-05890-x).

Record type: Article

Abstract

Summary: This study demonstrates a substantial and persistent anti-osteoporosis treatment gap in men and women ≥50 years old who sustained major osteoporotic fracture(s) between 2005 and 2014 in Denmark. This was not substantially reduced by including hospital-administered anti-osteoporosis treatments. Strengthened post-fracture organization of care and secondary fracture prevention is highly needed. Introduction: The purpose of this study was to evaluate the Danish anti-osteoporosis treatment gap from 2005 to 2014 in patients sustaining a major osteoporotic fracture (MOF), and to assess the impact of including hospital-administered anti-osteoporosis medications (AOM) on the treatment gap among these patients. Methods: In this retrospective, registry-based study, we included men and women aged 50 years or older and living in Denmark, who sustained at least one MOF between 2005 and 2014. We applied a repeated cross-sectional design to generate cohorts of patients sustaining a first MOF, hip, vertebral, humerus, or forearm fracture, respectively, within each calendar year. We evaluated the treatment gap as the proportion of patients within each cohort not receiving treatment with AOM within 1 year of the fracture. Hospital-administered AOM was identified by SKS code. Results: The treatment gap among MOF patients decreased from 85% in 2005 to 79% in 2014. The gap was smaller among hip and vertebral fracture patients as compared to humerus and forearm fracture patients, and it was smaller in women than in men. The use of hospital-administered AOM was relatively uncommon, with a maximum of 0.9% of MOF patients initiating hospital-administered AOM (in 2012). We observed substantial variations in this proportion between fracture types and gender. Hospital-administered AOM was most commonly used among vertebral fracture patients. Conclusion: A significant treatment gap among patients sustaining a major osteoporotic fracture was present throughout our analysis, and including hospital-administered AOM did not significantly improve the treatment gap assessment. Improved secondary fracture prevention is urgently needed.

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Accepted/In Press date: 11 February 2021
e-pub ahead of print date: 15 March 2021
Published date: October 2021
Additional Information: Publisher Copyright: © 2021, The Author(s).
Keywords: Bisphosphonate, Fracture, Fracture prevention, Osteoporosis, Osteoporosis treatment

Identifiers

Local EPrints ID: 447885
URI: http://eprints.soton.ac.uk/id/eprint/447885
ISSN: 0937-941X
PURE UUID: 59f04aba-225e-4139-bafd-c3d8e4133d85
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 25 Mar 2021 18:20
Last modified: 18 Mar 2024 02:46

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Contributors

Author: M.K. Skjodt
Author: M. Ernst
Author: Sara Khalid
Author: Cesar Libanati
Author: Cyrus Cooper ORCID iD
Author: Antonella Delmestri
Author: Katrine Hass Rubin
Author: M. Kassim Javaid
Author: Daniel Martínez-Laguna
Author: Emese Toth
Author: Daniel Prieto-Alhambra
Author: Bo Abrahamsen

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