Undertreatment of osteoporosis in women, based on detection of vertebral compression fractures on chest radiography

Philip J. Kroth, Michael Murray, Clement J. McDonald

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Fractures attributable to ostcoporosis are responsible for preventable suffering and health care costs. Until they experience a fracture, many older adults, particularly women, are unaware that they have osteoporosis. Although radiographs taken for reasons other than evaluating the possibility of osteoporosis may suggest the presence of fracture, such fractures often go undetected and effective treatments are not implemented. Objective: The goal of this study was to determine the adequacy of treatment of osteoporotic vertebral compression fractures in middle-aged and older women in an internal medicine clinic, as ascertained by reports of chest radiography. The hypothesis was that patients having chest radiographs with observable vertebral compression fractures often did not receive adequate treatment. Methods: This was a retrospective, cross-sectional study conducted at a general internal medicine clinic at a university-affiliated county hospital. The records of an academic internal medicine practice were searched to identify women aged ≥40 years with radiologic evidence of vertebral compression fractures during the period from June 1, 1992, through May 31, 2002. Electronic prescription records were then searched to determine whether patients had received a prescription for a medication for the treatment of osteoporosis. An analysis also was conducted to describe the frequency distribution of various medications for the treatment of osteoporosis. Results: One hundred thirteen women were identified who met the study criteria. Their mean (SD) age was 68.1 (21.9) years. Fifty-six (50%) of these women received pharmacologic treatment for osteoporosis. The most commonly prescribed medications were estrogens (35%), calcitonin (16%), and bisphosphonates (12%). Conclusions: No more than half of patients identified as having a vertebral compression fracture on chest radiography received even 1 prescription for the treatment of osteoporosis. Because this study did not examine adherence or long-term medication use, the proportion of women who received adequate osteoporosis therapy was probably much less than half. Physicians should be alert to the possible presence of vertebral compression fractures and take a more aggressive approach to treatment when a fracture is present.

Original languageEnglish
Pages (from-to)112-118
Number of pages7
JournalAmerican Journal Geriatric Pharmacotherapy
Volume2
Issue number2
DOIs
StatePublished - Jun 2004

Fingerprint

Compression Fractures
Radiography
Osteoporosis
Thorax
Internal Medicine
Therapeutics
Prescriptions
Electronic Prescribing
County Hospitals
Diphosphonates
Calcitonin
Psychological Stress
Health Care Costs
Estrogens
Cross-Sectional Studies
Physicians

Keywords

  • Bisphosphonates
  • Calcitonin
  • Osteoporosis
  • Vertebral fracture

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Geriatrics and Gerontology

Cite this

Undertreatment of osteoporosis in women, based on detection of vertebral compression fractures on chest radiography. / Kroth, Philip J.; Murray, Michael; McDonald, Clement J.

In: American Journal Geriatric Pharmacotherapy, Vol. 2, No. 2, 06.2004, p. 112-118.

Research output: Contribution to journalArticle

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abstract = "Background: Fractures attributable to ostcoporosis are responsible for preventable suffering and health care costs. Until they experience a fracture, many older adults, particularly women, are unaware that they have osteoporosis. Although radiographs taken for reasons other than evaluating the possibility of osteoporosis may suggest the presence of fracture, such fractures often go undetected and effective treatments are not implemented. Objective: The goal of this study was to determine the adequacy of treatment of osteoporotic vertebral compression fractures in middle-aged and older women in an internal medicine clinic, as ascertained by reports of chest radiography. The hypothesis was that patients having chest radiographs with observable vertebral compression fractures often did not receive adequate treatment. Methods: This was a retrospective, cross-sectional study conducted at a general internal medicine clinic at a university-affiliated county hospital. The records of an academic internal medicine practice were searched to identify women aged ≥40 years with radiologic evidence of vertebral compression fractures during the period from June 1, 1992, through May 31, 2002. Electronic prescription records were then searched to determine whether patients had received a prescription for a medication for the treatment of osteoporosis. An analysis also was conducted to describe the frequency distribution of various medications for the treatment of osteoporosis. Results: One hundred thirteen women were identified who met the study criteria. Their mean (SD) age was 68.1 (21.9) years. Fifty-six (50{\%}) of these women received pharmacologic treatment for osteoporosis. The most commonly prescribed medications were estrogens (35{\%}), calcitonin (16{\%}), and bisphosphonates (12{\%}). Conclusions: No more than half of patients identified as having a vertebral compression fracture on chest radiography received even 1 prescription for the treatment of osteoporosis. Because this study did not examine adherence or long-term medication use, the proportion of women who received adequate osteoporosis therapy was probably much less than half. Physicians should be alert to the possible presence of vertebral compression fractures and take a more aggressive approach to treatment when a fracture is present.",
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