The treatment gap after major osteoporotic fractures in Denmark 2005-2014 : a combined analysis including both prescription-based and hospital-administered anti-osteoporosis medications
Skjødt, M. K. (Holbæk Hospital (Dinamarca))
Ernst, M. T. (University of Southern Denmark. Department of Public Health, Clinical Pharmacology, Pharmacy and Environmental Medicine)
Khalid, Sara (Oxford University Hospitals. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences)
Libanati, C. (UCB Pharma)
Cooper, Cyrus (University of Southampton)
Delmestri, Antonella (Oxford University Hospitals. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences)
Rubin, K. H. (University of Southern Denmark)
Javaid, M. K. (Oxford University Hospitals. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences)
Martínez-Laguna, Daniel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Prieto-Alhambra, Daniel (Oxford University Hospitals. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences)
Abrahamsen, Bo (Oxford University Hospitals. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences)
Universitat Autònoma de Barcelona

Data:	2021
Resum:	This study demonstrates a substantial and persistent anti-osteoporosis treatment gap in men and women ≥50 years old who sustained major osteoporotic fracture(s) between 2005 and 2014 in Denmark. This was not substantially reduced by including hospital-administered anti-osteoporosis treatments. Strengthened post-fracture organization of care and secondary fracture prevention is highly needed. The purpose of this study was to evaluate the Danish anti-osteoporosis treatment gap from 2005 to 2014 in patients sustaining a major osteoporotic fracture (MOF), and to assess the impact of including hospital-administered anti-osteoporosis medications (AOM) on the treatment gap among these patients. In this retrospective, registry-based study, we included men and women aged 50 years or older and living in Denmark, who sustained at least one MOF between 2005 and 2014. We applied a repeated cross-sectional design to generate cohorts of patients sustaining a first MOF, hip, vertebral, humerus, or forearm fracture, respectively, within each calendar year. We evaluated the treatment gap as the proportion of patients within each cohort not receiving treatment with AOM within 1 year of the fracture. Hospital-administered AOM was identified by SKS code. The treatment gap among MOF patients decreased from 85% in 2005 to 79% in 2014. The gap was smaller among hip and vertebral fracture patients as compared to humerus and forearm fracture patients, and it was smaller in women than in men. The use of hospital-administered AOM was relatively uncommon, with a maximum of 0. 9% of MOF patients initiating hospital-administered AOM (in 2012). We observed substantial variations in this proportion between fracture types and gender. Hospital-administered AOM was most commonly used among vertebral fracture patients. A significant treatment gap among patients sustaining a major osteoporotic fracture was present throughout our analysis, and including hospital-administered AOM did not significantly improve the treatment gap assessment. Improved secondary fracture prevention is urgently needed. The online version contains supplementary material available at 10. 1007/s00198-021-05890-x.
Nota:	Funding: UCB funded this study
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Estudi clínic ; recerca ; Versió publicada
Matèria:	Osteoporosis ; Fracture ; Fracture prevention ; Osteoporosis treatment ; Bisphosphonate
Publicat a:	Osteoporosis International, Vol. 32 (march 2021) , p. 1961-1971, ISSN 1433-2965

DOI: 10.1007/s00198-021-05890-x
PMID: 33721032

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