A population-based analysis of the post-fracture care gap 1996–2008: the situation is not improving
Summary The post-fracture care gap has not narrowed in recent years. Following an initial improvement, rates of medication initiation have actually declined. Introduction The current study characterizes temporal changes in post-fracture bone mineral density (BMD) testing or osteoporosis treatment in...
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| Veröffentlicht in: | Osteoporosis international 2012-05, Vol.23 (5), p.1623-1629 |
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| creator | Leslie, W. D. Giangregorio, L. M. Yogendran, M. Azimaee, M. Morin, S. Metge, C. Caetano, P. Lix, L. M. |
| description | Summary
The post-fracture care gap has not narrowed in recent years. Following an initial improvement, rates of medication initiation have actually declined.
Introduction
The current study characterizes temporal changes in post-fracture bone mineral density (BMD) testing or osteoporosis treatment initiation from 1996/1997 to 2007/2008.
Methods
A population-based administrative data repository for Manitoba, Canada was accessed to identify non-traumatic fractures in individuals aged 50 years and older. Outcomes included BMD testing or dispensation of an osteoporosis medication in the 12 months following the fracture.
Results
Thirty thousand nine hundred and twenty (30,920) fracture events met the inclusion criteria; 15,670 affected major osteoporotic fracture sites. Based on either BMD testing or treatment initiation, intervention rates reached a maximum of only 15.5% in 2003/2004, compared with 6.3% in 1996/1997, and 13.2% in 2007/2008 (
p
-for-trend |
| doi_str_mv | 10.1007/s00198-011-1630-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1009526023</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2660289951</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-5e85d389df1a8ed740c5797fbafa7f1c8b09da3734f7b81f0e607ff65b6519eb3</originalsourceid><addsrcrecordid>eNp1kctKxDAUhoMozjj6AG6k4MZN9JymzcWdiDcYcKPgrqRtMnbotDVpBXe-g2_ok5i5KCK4SRb5_u-Q8xNyiHCKAOLMA6CSFBApcgYUt8gYE8ZorHi6TcagmKAqwacR2fN-DiGjlNgloxgTwYHJMTEXUdd2Q637qm1orr0pI93o-s1XPmpt1D-bAPieWqeLfnAmKnQ4ZrqLUCn--f4RA8jzFeerflh5opBt2j6qFp1rX6tmtk92rK69OdjcE_J4ffVweUun9zd3lxdTWjAR9zQ1Mi2ZVKVFLU0pEihSoYTNtdXCYiFzUKVmgiVW5BItGA7CWp7mPEVlcjYhJ2tvmPsyGN9ni8oXpq51Y9rBZ2FrKo05xCygx3_QeTu48PMlhQwVl7CkcE0VrvXeGZt1rlpo9xagpU1k6w6y0EG27CDDkDnamId8YcqfxPfSAxCvAR-emplxv0f_Z_0CHXiRQA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1013196803</pqid></control><display><type>article</type><title>A population-based analysis of the post-fracture care gap 1996–2008: the situation is not improving</title><source>MEDLINE</source><source>Springer Journals</source><creator>Leslie, W. D. ; Giangregorio, L. M. ; Yogendran, M. ; Azimaee, M. ; Morin, S. ; Metge, C. ; Caetano, P. ; Lix, L. M.</creator><creatorcontrib>Leslie, W. D. ; Giangregorio, L. M. ; Yogendran, M. ; Azimaee, M. ; Morin, S. ; Metge, C. ; Caetano, P. ; Lix, L. M.</creatorcontrib><description>Summary
The post-fracture care gap has not narrowed in recent years. Following an initial improvement, rates of medication initiation have actually declined.
Introduction
The current study characterizes temporal changes in post-fracture bone mineral density (BMD) testing or osteoporosis treatment initiation from 1996/1997 to 2007/2008.
Methods
A population-based administrative data repository for Manitoba, Canada was accessed to identify non-traumatic fractures in individuals aged 50 years and older. Outcomes included BMD testing or dispensation of an osteoporosis medication in the 12 months following the fracture.
Results
Thirty thousand nine hundred and twenty (30,920) fracture events met the inclusion criteria; 15,670 affected major osteoporotic fracture sites. Based on either BMD testing or treatment initiation, intervention rates reached a maximum of only 15.5% in 2003/2004, compared with 6.3% in 1996/1997, and 13.2% in 2007/2008 (
p
-for-trend < 0.001). Post-fracture BMD testing increased from 0.7% in 1996/1997 to 8.9% 2007/2008 (
p
-for-trend < 0.001). Osteoporosis medication use increased from 6.1% in 1996/1997 to 12.3% in 2001/2002 and then progressively declined to 5.9% by 2007/2008 (
p
-for-trend = 0.025). Similar trends were observed when only major osteoporotic fractures were included. The initiation of BMD testing or medication varied according to age, gender, geographic region, and income.
Conclusion
Despite increased attention to gaps in osteoporosis management post-fracture in the last 10 years, the situation has not improved: in 2007/20008, fewer than 20% of untreated individuals with a low-trauma fracture received intervention. Novel strategies are required to disseminate and implement best practices at the point of care to reduce the risk of recurrent fractures.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-011-1630-1</identifier><identifier>PMID: 21476038</identifier><language>eng</language><publisher>London: Springer-Verlag</publisher><subject>Absorptiometry, Photon - utilization ; Age Factors ; Aged ; Bone density ; Bone Density - physiology ; Bone Density Conservation Agents - therapeutic use ; Cohort Studies ; Delivery of Health Care - standards ; Delivery of Health Care - statistics & numerical data ; Delivery of Health Care - trends ; Diagnostic tests ; Disease Management ; Drug therapy ; Drug Utilization - statistics & numerical data ; Drug Utilization - trends ; Endocrinology ; Female ; Fractures ; Humans ; Male ; Manitoba - epidemiology ; Medicine ; Medicine & Public Health ; Middle Aged ; Orthopedics ; Osteoporosis ; Osteoporosis - diagnosis ; Osteoporosis - drug therapy ; Osteoporosis - epidemiology ; Osteoporosis - physiopathology ; Osteoporotic Fractures - epidemiology ; Osteoporotic Fractures - physiopathology ; Osteoporotic Fractures - prevention & control ; Retrospective Studies ; Rheumatology ; Secondary Prevention ; Sex Factors ; Short Communication</subject><ispartof>Osteoporosis international, 2012-05, Vol.23 (5), p.1623-1629</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2011</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-5e85d389df1a8ed740c5797fbafa7f1c8b09da3734f7b81f0e607ff65b6519eb3</citedby><cites>FETCH-LOGICAL-c372t-5e85d389df1a8ed740c5797fbafa7f1c8b09da3734f7b81f0e607ff65b6519eb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-011-1630-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-011-1630-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21476038$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leslie, W. D.</creatorcontrib><creatorcontrib>Giangregorio, L. M.</creatorcontrib><creatorcontrib>Yogendran, M.</creatorcontrib><creatorcontrib>Azimaee, M.</creatorcontrib><creatorcontrib>Morin, S.</creatorcontrib><creatorcontrib>Metge, C.</creatorcontrib><creatorcontrib>Caetano, P.</creatorcontrib><creatorcontrib>Lix, L. M.</creatorcontrib><title>A population-based analysis of the post-fracture care gap 1996–2008: the situation is not improving</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
The post-fracture care gap has not narrowed in recent years. Following an initial improvement, rates of medication initiation have actually declined.
Introduction
The current study characterizes temporal changes in post-fracture bone mineral density (BMD) testing or osteoporosis treatment initiation from 1996/1997 to 2007/2008.
Methods
A population-based administrative data repository for Manitoba, Canada was accessed to identify non-traumatic fractures in individuals aged 50 years and older. Outcomes included BMD testing or dispensation of an osteoporosis medication in the 12 months following the fracture.
Results
Thirty thousand nine hundred and twenty (30,920) fracture events met the inclusion criteria; 15,670 affected major osteoporotic fracture sites. Based on either BMD testing or treatment initiation, intervention rates reached a maximum of only 15.5% in 2003/2004, compared with 6.3% in 1996/1997, and 13.2% in 2007/2008 (
p
-for-trend < 0.001). Post-fracture BMD testing increased from 0.7% in 1996/1997 to 8.9% 2007/2008 (
p
-for-trend < 0.001). Osteoporosis medication use increased from 6.1% in 1996/1997 to 12.3% in 2001/2002 and then progressively declined to 5.9% by 2007/2008 (
p
-for-trend = 0.025). Similar trends were observed when only major osteoporotic fractures were included. The initiation of BMD testing or medication varied according to age, gender, geographic region, and income.
Conclusion
Despite increased attention to gaps in osteoporosis management post-fracture in the last 10 years, the situation has not improved: in 2007/20008, fewer than 20% of untreated individuals with a low-trauma fracture received intervention. Novel strategies are required to disseminate and implement best practices at the point of care to reduce the risk of recurrent fractures.</description><subject>Absorptiometry, Photon - utilization</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Bone density</subject><subject>Bone Density - physiology</subject><subject>Bone Density Conservation Agents - therapeutic use</subject><subject>Cohort Studies</subject><subject>Delivery of Health Care - standards</subject><subject>Delivery of Health Care - statistics & numerical data</subject><subject>Delivery of Health Care - trends</subject><subject>Diagnostic tests</subject><subject>Disease Management</subject><subject>Drug therapy</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Drug Utilization - trends</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Fractures</subject><subject>Humans</subject><subject>Male</subject><subject>Manitoba - epidemiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Osteoporosis - diagnosis</subject><subject>Osteoporosis - drug therapy</subject><subject>Osteoporosis - epidemiology</subject><subject>Osteoporosis - physiopathology</subject><subject>Osteoporotic Fractures - epidemiology</subject><subject>Osteoporotic Fractures - physiopathology</subject><subject>Osteoporotic Fractures - prevention & control</subject><subject>Retrospective Studies</subject><subject>Rheumatology</subject><subject>Secondary Prevention</subject><subject>Sex Factors</subject><subject>Short Communication</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kctKxDAUhoMozjj6AG6k4MZN9JymzcWdiDcYcKPgrqRtMnbotDVpBXe-g2_ok5i5KCK4SRb5_u-Q8xNyiHCKAOLMA6CSFBApcgYUt8gYE8ZorHi6TcagmKAqwacR2fN-DiGjlNgloxgTwYHJMTEXUdd2Q637qm1orr0pI93o-s1XPmpt1D-bAPieWqeLfnAmKnQ4ZrqLUCn--f4RA8jzFeerflh5opBt2j6qFp1rX6tmtk92rK69OdjcE_J4ffVweUun9zd3lxdTWjAR9zQ1Mi2ZVKVFLU0pEihSoYTNtdXCYiFzUKVmgiVW5BItGA7CWp7mPEVlcjYhJ2tvmPsyGN9ni8oXpq51Y9rBZ2FrKo05xCygx3_QeTu48PMlhQwVl7CkcE0VrvXeGZt1rlpo9xagpU1k6w6y0EG27CDDkDnamId8YcqfxPfSAxCvAR-emplxv0f_Z_0CHXiRQA</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Leslie, W. D.</creator><creator>Giangregorio, L. M.</creator><creator>Yogendran, M.</creator><creator>Azimaee, M.</creator><creator>Morin, S.</creator><creator>Metge, C.</creator><creator>Caetano, P.</creator><creator>Lix, L. M.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>A population-based analysis of the post-fracture care gap 1996–2008: the situation is not improving</title><author>Leslie, W. D. ; Giangregorio, L. M. ; Yogendran, M. ; Azimaee, M. ; Morin, S. ; Metge, C. ; Caetano, P. ; Lix, L. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-5e85d389df1a8ed740c5797fbafa7f1c8b09da3734f7b81f0e607ff65b6519eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Absorptiometry, Photon - utilization</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Bone density</topic><topic>Bone Density - physiology</topic><topic>Bone Density Conservation Agents - therapeutic use</topic><topic>Cohort Studies</topic><topic>Delivery of Health Care - standards</topic><topic>Delivery of Health Care - statistics & numerical data</topic><topic>Delivery of Health Care - trends</topic><topic>Diagnostic tests</topic><topic>Disease Management</topic><topic>Drug therapy</topic><topic>Drug Utilization - statistics & numerical data</topic><topic>Drug Utilization - trends</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Fractures</topic><topic>Humans</topic><topic>Male</topic><topic>Manitoba - epidemiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Osteoporosis - diagnosis</topic><topic>Osteoporosis - drug therapy</topic><topic>Osteoporosis - epidemiology</topic><topic>Osteoporosis - physiopathology</topic><topic>Osteoporotic Fractures - epidemiology</topic><topic>Osteoporotic Fractures - physiopathology</topic><topic>Osteoporotic Fractures - prevention & control</topic><topic>Retrospective Studies</topic><topic>Rheumatology</topic><topic>Secondary Prevention</topic><topic>Sex Factors</topic><topic>Short Communication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leslie, W. D.</creatorcontrib><creatorcontrib>Giangregorio, L. M.</creatorcontrib><creatorcontrib>Yogendran, M.</creatorcontrib><creatorcontrib>Azimaee, M.</creatorcontrib><creatorcontrib>Morin, S.</creatorcontrib><creatorcontrib>Metge, C.</creatorcontrib><creatorcontrib>Caetano, P.</creatorcontrib><creatorcontrib>Lix, L. M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leslie, W. D.</au><au>Giangregorio, L. M.</au><au>Yogendran, M.</au><au>Azimaee, M.</au><au>Morin, S.</au><au>Metge, C.</au><au>Caetano, P.</au><au>Lix, L. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A population-based analysis of the post-fracture care gap 1996–2008: the situation is not improving</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>23</volume><issue>5</issue><spage>1623</spage><epage>1629</epage><pages>1623-1629</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
The post-fracture care gap has not narrowed in recent years. Following an initial improvement, rates of medication initiation have actually declined.
Introduction
The current study characterizes temporal changes in post-fracture bone mineral density (BMD) testing or osteoporosis treatment initiation from 1996/1997 to 2007/2008.
Methods
A population-based administrative data repository for Manitoba, Canada was accessed to identify non-traumatic fractures in individuals aged 50 years and older. Outcomes included BMD testing or dispensation of an osteoporosis medication in the 12 months following the fracture.
Results
Thirty thousand nine hundred and twenty (30,920) fracture events met the inclusion criteria; 15,670 affected major osteoporotic fracture sites. Based on either BMD testing or treatment initiation, intervention rates reached a maximum of only 15.5% in 2003/2004, compared with 6.3% in 1996/1997, and 13.2% in 2007/2008 (
p
-for-trend < 0.001). Post-fracture BMD testing increased from 0.7% in 1996/1997 to 8.9% 2007/2008 (
p
-for-trend < 0.001). Osteoporosis medication use increased from 6.1% in 1996/1997 to 12.3% in 2001/2002 and then progressively declined to 5.9% by 2007/2008 (
p
-for-trend = 0.025). Similar trends were observed when only major osteoporotic fractures were included. The initiation of BMD testing or medication varied according to age, gender, geographic region, and income.
Conclusion
Despite increased attention to gaps in osteoporosis management post-fracture in the last 10 years, the situation has not improved: in 2007/20008, fewer than 20% of untreated individuals with a low-trauma fracture received intervention. Novel strategies are required to disseminate and implement best practices at the point of care to reduce the risk of recurrent fractures.</abstract><cop>London</cop><pub>Springer-Verlag</pub><pmid>21476038</pmid><doi>10.1007/s00198-011-1630-1</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0937-941X |
| ispartof | Osteoporosis international, 2012-05, Vol.23 (5), p.1623-1629 |
| issn | 0937-941X 1433-2965 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1009526023 |
| source | MEDLINE; Springer Journals |
| subjects | Absorptiometry, Photon - utilization Age Factors Aged Bone density Bone Density - physiology Bone Density Conservation Agents - therapeutic use Cohort Studies Delivery of Health Care - standards Delivery of Health Care - statistics & numerical data Delivery of Health Care - trends Diagnostic tests Disease Management Drug therapy Drug Utilization - statistics & numerical data Drug Utilization - trends Endocrinology Female Fractures Humans Male Manitoba - epidemiology Medicine Medicine & Public Health Middle Aged Orthopedics Osteoporosis Osteoporosis - diagnosis Osteoporosis - drug therapy Osteoporosis - epidemiology Osteoporosis - physiopathology Osteoporotic Fractures - epidemiology Osteoporotic Fractures - physiopathology Osteoporotic Fractures - prevention & control Retrospective Studies Rheumatology Secondary Prevention Sex Factors Short Communication |
| title | A population-based analysis of the post-fracture care gap 1996–2008: the situation is not improving |
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