Treatment for older men with fractures

Angela Shepherd, A. R. Cass, L. A. Ray, A. Tan, G. S. Wilkinson

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Less than 10% of men receive osteoporosis treatment, even after a fracture. A study of 17,683 men revealed that older men, those with spinal fractures, and those taking steroids or antidepressants are more likely to receive treatment after a fracture. Seeing a primary care physician also increases osteoporosis treatment rates. Introduction: In 2000, the FDA approved bisphosphonates for the treatment of osteoporosis in men. The purpose of this study is to estimate the frequency of bisphosphonate therapy within 12 months following a fracture and describe patient/physician factors associated with treatment. Methods: Health insurance claims for 17,683 men ≥65 years of age, who had a claim for an incident fracture from 2000 to 2005, were followed for at least 6 months post-fracture for the initiation of treatment with a bisphosphonate. Patient characteristics, diagnostic procedures, therapies, co-morbidities, and provider characteristics were compared for men who received treatment with those who did not. Results: Eight percent of men (n = 1,434) received bisphosphonate therapy. Overall treatment increased from 7% in 2001 to 9% in 2005 (p < 0.001). Treatment for hip fractures remained at 7% (p = 0.747). Treatment increased with age: 6% in men aged 65-69 compared to 11.6% in men aged 85-89 (p < 0.001). Factors associated with treatment included: diagnosis of osteoporosis (OR = 8.8; 95% CI, 7.7, 10.4), glucocorticoid therapy (OR = 3.2; 95% CI, 2.4, 4.3), bone mineral density measurement (OR = 3.4; 95% CI, 2.9, 4.0), and antidepressant therapy with tricyclics (OR = 2.0; 95% CI, 1.2, 3.5) or selective serotonin reuptake inhibitors (OR = 1.7; 95% CI, 1.3, 2.4). Men with vertebral fractures (OR = 2.2; 95% CI, 1.8, 2.6) and men seen by primary physicians (OR = 2.6; 95% CI, 2.3, 3.1) were more likely to receive treatment. Conclusions: Less than 10% of men received bisphosphonate therapy following a low-impact fracture. Men with a primary physician were more likely to receive bisphosphonate therapy; however, <25% of men were seen by a primary physician.

Original languageEnglish (US)
Pages (from-to)1041-1051
Number of pages11
JournalOsteoporosis International
Volume23
Issue number3
DOIs
StatePublished - Mar 2012

Fingerprint

Diphosphonates
Therapeutics
Osteoporosis
Physicians
Antidepressive Agents
Spinal Fractures
Hip Fractures
Serotonin Uptake Inhibitors
Primary Care Physicians
Health Insurance
Bone Density
Glucocorticoids
Steroids
Morbidity

Keywords

  • Bisphosphonates
  • Fractures
  • Men
  • Osteoporosis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Shepherd, A., Cass, A. R., Ray, L. A., Tan, A., & Wilkinson, G. S. (2012). Treatment for older men with fractures. Osteoporosis International, 23(3), 1041-1051. https://doi.org/10.1007/s00198-011-1681-3

Treatment for older men with fractures. / Shepherd, Angela; Cass, A. R.; Ray, L. A.; Tan, A.; Wilkinson, G. S.

In: Osteoporosis International, Vol. 23, No. 3, 03.2012, p. 1041-1051.

Research output: Contribution to journalArticle

Shepherd, A, Cass, AR, Ray, LA, Tan, A & Wilkinson, GS 2012, 'Treatment for older men with fractures', Osteoporosis International, vol. 23, no. 3, pp. 1041-1051. https://doi.org/10.1007/s00198-011-1681-3
Shepherd, Angela ; Cass, A. R. ; Ray, L. A. ; Tan, A. ; Wilkinson, G. S. / Treatment for older men with fractures. In: Osteoporosis International. 2012 ; Vol. 23, No. 3. pp. 1041-1051.
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abstract = "Less than 10{\%} of men receive osteoporosis treatment, even after a fracture. A study of 17,683 men revealed that older men, those with spinal fractures, and those taking steroids or antidepressants are more likely to receive treatment after a fracture. Seeing a primary care physician also increases osteoporosis treatment rates. Introduction: In 2000, the FDA approved bisphosphonates for the treatment of osteoporosis in men. The purpose of this study is to estimate the frequency of bisphosphonate therapy within 12 months following a fracture and describe patient/physician factors associated with treatment. Methods: Health insurance claims for 17,683 men ≥65 years of age, who had a claim for an incident fracture from 2000 to 2005, were followed for at least 6 months post-fracture for the initiation of treatment with a bisphosphonate. Patient characteristics, diagnostic procedures, therapies, co-morbidities, and provider characteristics were compared for men who received treatment with those who did not. Results: Eight percent of men (n = 1,434) received bisphosphonate therapy. Overall treatment increased from 7{\%} in 2001 to 9{\%} in 2005 (p < 0.001). Treatment for hip fractures remained at 7{\%} (p = 0.747). Treatment increased with age: 6{\%} in men aged 65-69 compared to 11.6{\%} in men aged 85-89 (p < 0.001). Factors associated with treatment included: diagnosis of osteoporosis (OR = 8.8; 95{\%} CI, 7.7, 10.4), glucocorticoid therapy (OR = 3.2; 95{\%} CI, 2.4, 4.3), bone mineral density measurement (OR = 3.4; 95{\%} CI, 2.9, 4.0), and antidepressant therapy with tricyclics (OR = 2.0; 95{\%} CI, 1.2, 3.5) or selective serotonin reuptake inhibitors (OR = 1.7; 95{\%} CI, 1.3, 2.4). Men with vertebral fractures (OR = 2.2; 95{\%} CI, 1.8, 2.6) and men seen by primary physicians (OR = 2.6; 95{\%} CI, 2.3, 3.1) were more likely to receive treatment. Conclusions: Less than 10{\%} of men received bisphosphonate therapy following a low-impact fracture. Men with a primary physician were more likely to receive bisphosphonate therapy; however, <25{\%} of men were seen by a primary physician.",
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N2 - Less than 10% of men receive osteoporosis treatment, even after a fracture. A study of 17,683 men revealed that older men, those with spinal fractures, and those taking steroids or antidepressants are more likely to receive treatment after a fracture. Seeing a primary care physician also increases osteoporosis treatment rates. Introduction: In 2000, the FDA approved bisphosphonates for the treatment of osteoporosis in men. The purpose of this study is to estimate the frequency of bisphosphonate therapy within 12 months following a fracture and describe patient/physician factors associated with treatment. Methods: Health insurance claims for 17,683 men ≥65 years of age, who had a claim for an incident fracture from 2000 to 2005, were followed for at least 6 months post-fracture for the initiation of treatment with a bisphosphonate. Patient characteristics, diagnostic procedures, therapies, co-morbidities, and provider characteristics were compared for men who received treatment with those who did not. Results: Eight percent of men (n = 1,434) received bisphosphonate therapy. Overall treatment increased from 7% in 2001 to 9% in 2005 (p < 0.001). Treatment for hip fractures remained at 7% (p = 0.747). Treatment increased with age: 6% in men aged 65-69 compared to 11.6% in men aged 85-89 (p < 0.001). Factors associated with treatment included: diagnosis of osteoporosis (OR = 8.8; 95% CI, 7.7, 10.4), glucocorticoid therapy (OR = 3.2; 95% CI, 2.4, 4.3), bone mineral density measurement (OR = 3.4; 95% CI, 2.9, 4.0), and antidepressant therapy with tricyclics (OR = 2.0; 95% CI, 1.2, 3.5) or selective serotonin reuptake inhibitors (OR = 1.7; 95% CI, 1.3, 2.4). Men with vertebral fractures (OR = 2.2; 95% CI, 1.8, 2.6) and men seen by primary physicians (OR = 2.6; 95% CI, 2.3, 3.1) were more likely to receive treatment. Conclusions: Less than 10% of men received bisphosphonate therapy following a low-impact fracture. Men with a primary physician were more likely to receive bisphosphonate therapy; however, <25% of men were seen by a primary physician.

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