Study examines outpatient use of medication and lifestyle counseling to manage osteoporosis
An estimated 12.5 percent of Americans aged 50 years and older have osteoporosis (severe loss of bone mass). Women are particularly affected, with one in two expected to have a fracture related to bone loss during their lifetime. Use of medication for osteoporosis does not differ significantly among patients in physician offices or hospital-based clinics. However, those treated in clinics are less likely to receive nonmedication interventions to manage the condition, according to a new study.
Researchers from Howard University and Washington Hospital Center in Washington, D.C., analyzed patient visits for osteoporosis made over a period of 5 years. The prevalence of osteoporosis and fracture was similar among office-based and clinic-based patients. More than half (53.2 percent) of all patients received medication therapy, primarily in the form of bisphosphonates (36 percent), followed by calcium and vitamin D supplementation (23.9 percent).
The most commonly used nonmedication interventions, documented in 31.5 percent of all visits, were diet/nutrition counseling (19.4 percent) and exercise (16.7 percent). Yet patients treated in hospital-based clinics were 40 percent less likely to receive them than patients in office-based clinics. Patterns of care also varied by certain visit characteristics, including insurance type, age, and sex. For example, men were 40 percent less likely than women to receive some form of treatment for their osteoporosis.
Patients aged 80 years or older were 40 percent less likely to receive nonmedication therapy than those aged 60 to 69 years. Visits by publicly insured patients were 30 percent less likely to involve medication than visits by patients with other sources of payment. However, no racial differences in treatment were observed. The study was supported in part by the Agency for Healthcare Research and Quality (HS11673).
See "Osteoporosis pharmacotherapy and counseling services in U.S. ambulatory care clinics: Opportunities for multidisciplinary interventions," by Anna Teschemaker, B.S., Euni Lee, Pharm.D., Ph.D., Zhenyi Xue, M.S., and Anthony K. Wutoh, Ph.D., in the December 2008 American Journal of Geriatric Pharmacotherapy 6(5), pp. 240-248.
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