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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results1 to 8 of 8 Research Studies Displayed
Fink HA, MacDonald R, Forte ML
Long-term drug therapy and drug discontinuations and holidays for osteoporosis fracture prevention: a systematic review.
Optimal long-term osteoporosis drug treatment (ODT) is uncertain. The purpose of this study was to summarize the effects of long-term ODT and ODT discontinuation and holidays. The investigators concluded that: long-term alendronate and zoledronic acid therapies reduce fracture risk in women with osteoporosis; long-term bisphosphonate treatment may increase risk for rare adverse events, and continuing treatment beyond 3 to 5 years may reduce risk for vertebral fractures; and long-term hormone therapy reduces hip fracture risks but has serious harms.
Citation: Fink HA, MacDonald R, Forte ML . Long-term drug therapy and drug discontinuations and holidays for osteoporosis fracture prevention: a systematic review. Ann Intern Med 2019 Jul 2;171(1):37-50. doi: 10.7326/m19-0533.
Keywords: Evidence-Based Practice, Injuries and Wounds, Medication, Osteoporosis, Outcomes, Patient-Centered Outcomes Research, Prevention
Hall SF, Wright NC, Wolinsky FD
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
There is a robust body of literature addressing undertreatment in osteoporosis, but limited data addressing overtreatment. In this study, the investigators sought to understand overtreatment as this understanding is important to minimizing harm and decrease costs. The investigators found that in their sample of older adults, overuse of osteoporosis pharmacotherapy was only 8.1%. Nevertheless, they concluded, overtreatment exposed patients to possible risk with negligible chance of benefit and should be minimized.
Citation: Hall SF, Wright NC, Wolinsky FD . The prevalence of overtreatment of osteoporosis: results from the PAADRN trial. Arch Osteoporos 2018 Sep 28;13(1):103. doi: 10.1007/s11657-018-0517-6..
Keywords: Osteoporosis, Decision Making, Medication, Elderly, Patient-Centered Healthcare, Patient and Family Engagement, Care Management
Goodwin JS, Zhou J, Kuo YF
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
The researchers compared the risk of jaw osteonecrosis after intravenous (IV) bisphosphonate administered to patients with cancer vs patients without cancer. During follow-up, 40 (0.42 percent) out of 9,482 patients with cancer developed probable jaw osteonecrosis compared with 8 (0.05 percent) out of 16,046 patients without cancer.
Citation: Goodwin JS, Zhou J, Kuo YF . Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer. Mayo Clin Proc 2017 Jan;92(1):106-13. doi: 10.1016/j.mayocp.2016.09.015.
Keywords: Cancer, Osteoporosis, Risk, Medication, Patient-Centered Outcomes Research
Cram P, Wolinsky FD, Lou Y
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
In a clinical trial of 7749 patients, the researchers tested whether usual care augmented by a tailored patient-activation DXA result letter accompanied by an educational brochure would improve guideline-concordant pharmacological treatment compared to usual care only. They found that treatment rates did not improve.
Citation: Cram P, Wolinsky FD, Lou Y . Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial. Osteoporos Int 2016 Dec;27(12):3513-24. doi: 10.1007/s00198-016-3681-9.
Keywords: Education: Patient and Caregiver, Guidelines, Medication, Osteoporosis, Patient and Family Engagement
Fenton JJ, Robbins JA, Amarnath AL
Osteoporosis overtreatment in a regional health care system.
The researchers estimated the frequency of osteoporosis overtreatment in a regional health care system where DXA reports routinely include T scores for anatomic sites (e.g., lateral lumbar spine) that the International Society for Clinical Densitometry does not recommend for osteoporosis diagnosis. They found that two-thirds of new osteoporosis drug prescriptions were potentially inappropriate.
Citation: Fenton JJ, Robbins JA, Amarnath AL . Osteoporosis overtreatment in a regional health care system. JAMA Intern Med 2016 Mar;176(3):391-3. doi: 10.1001/jamainternmed.2015.6020.
Keywords: Decision Making, Diagnostic Safety and Quality, Medication, Osteoporosis
Hernandez I, Zhang Y
Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis.
This study compared clinical and economic outcomes between teriparatide (monthly costs $1120) and bisphosphonates (monthly costs $14) among postmenopausal women with osteoporosis. It found that teriparatide users had higher risk of fracture and higher costs, compared with similar bisphosphonates users. The hazard ratios of fracture for teriparatide relative to bisphosphonates ranged from 1.37 to 2.12, depending on methods.
Citation: Hernandez I, Zhang Y . Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis. J Eval Clin Pract 2015 Oct;21(5):840-7. doi: 10.1111/jep.12389.
Keywords: Medication, Women, Osteoporosis, Healthcare Costs
LaFleur J, DuVall SL, Wilson T
Analysis of osteoporosis treatment patterns with bisphosphonates and outcomes among postmenopausal veterans.
This study evaluated bisphosphonate change behaviors (switching, discontinuing, or reinitiating) over time, as well as fractures and costs, among a large, national cohort of postmenopausal veterans. It found that most bisphosphonate patients discontinue treatment at some point, which did not significantly increase the risk of fracture in this majority non-high risk population. Bisphosphonate change behaviors were associated with significantly lower osteoporosis costs, but significantly higher total costs.
Citation: LaFleur J, DuVall SL, Wilson T . Analysis of osteoporosis treatment patterns with bisphosphonates and outcomes among postmenopausal veterans. Bone 2015 Sep;78:174-85. doi: 10.1016/j.bone.2015.04.022..
Keywords: Osteoporosis, Medication, Elderly, Injuries and Wounds
Yun H, Delzell E, Saag KG
Fractures and mortality in relation to different osteoporosis treatments.
The researchers aimed to determine if fracture and mortality rates vary among patients initiating different osteoporosis medications. They found that IV ibandronate and calcitonin were associated with higher rates of some types of fracture when compared to IV zolendronic acid. The relatively high mortality associated with use of calcitonin may reflect the poorer health of users of this agent.
Citation: Yun H, Delzell E, Saag KG . Fractures and mortality in relation to different osteoporosis treatments. Clin Exp Rheumatol 2015 May-Jun;33(3):302-9..
Keywords: Osteoporosis, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research