Drop in osteoporosis treatment initiation after hip fracture

In recent years there have been low rates of osteoporosis treatment initiation after a hip fracture, according to research published in the July 20 issue of JAMA Network Open.

Using a commercial insurance claims database, Rishi J. Desai, Ph.D., from Brigham and Women’s Hospital in Boston, and colleagues analyzed osteoporosis treatment initiation rates between Jan. 1, 2004, and Sept. 30, 2015, among patients 50 years and older who had a hip fracture (97,169 patients; 66 percent women). Furthermore, the authors estimated the risk reduction in subsequent non-vertebral fracturesassociated with treatment initiation in patients with hip fracture.

The researchers found that over the study period there was a continuous decline in post-hip-fracture osteoporosis medication initiation rates (9.8 percent in 2004 to 3.3 percent in 2015). The hospital preference instrumental variable had a stronger association with treatment than the other three instrumental variables (specialist access, calendar year, and geographic variation) during the effectiveness analyses. With osteoporosis treatment initiation there was a rate difference of 4.2 events per 100 person-years (compared with non-use) in subsequent fractures based on instrumental variable analysis with hospital preference.

“Low rates of osteoporosis treatment initiation after a hip fracture in recent years were observed,” the authors write. “Clinically meaningful reduction in subsequent nonvertebral fracture rates associated with treatment suggests that improving prescriber adherence to guidelines and patient adherence to prescribed regimens may result in notable public health benefit.”

Several authors disclosed financial ties to pharmaceutical companies, including Merck, which funded the study.

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More information: Abstract/Full Text

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