Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective study

Alves, Sandra Maria Ferreira; Economou, Theo; Oliveira, CM; Ribeiro, Ana Isabel; Nevès, Nuno; Gómez‐Barrena, Enrique; Pina, Maria de Fátima de

doi:10.1016/j.bone.2012.12.014

Cited by 20 publications

(14 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A U-shape relation between BMD and SES was also found in Australia (women, over 18 years) -individuals living in the extreme categories of SES had lower Bone Mineral Density (BMD) [36] For women, the age interaction with SES was not so clear: older women from areas in the medium SES had lower risk compared to women from lower SES areas and we need further studies to understand if this pattern is related to risk factors such as obesity, physical activity, occupational work, etc; risk for women in the age group 70-74 years was similar in the three SES areas and this may be due to the fact that in Portugal the health guidelines for osteoporosis prevention are mainly focusing in women between 65-74 ages [37].…”

Section: Discussionmentioning

confidence: 99%

The interactions between municipal socioeconomic status and age on hip fracture risk

et al. 2014

View full text Add to dashboard Cite

declare that they have no conflict of interest. Role of funding source:The funder Fundação para a Ciência e Tecnologia -FCT has no role in this paper. Mini-abstractAge modifies the effect of area-level socioeconomic status (SES) in the risk of fragility hip fractures (HF).For older individuals risk of HF increases as SES increases. For younger, risk of HF increases as SES decreases. Our study may aid decisions makers and medical guidelines for HF prevention. Background:The effect of socioeconomic status (SES) on hip fracture (HF) incidence remains unclear.Objective: To evaluate the association between HF incidence and municipality-level SES as well as interactions between age and SES. and to analyze the interaction between age and SES, after adjusting for rural conditions. MethodsResults: There were 96,905 HF, 77.3% of which were on women who on average were older than men (mean age 81.2±8.5 vs 78.2±10.1 years) at admission (p<0.001). In women, there was a lower risk associated with better SES: RR=0.83 (95%CrI 0.65-1.00) for affluent versus deprived. There was an inverse association between SES and HF incidence rate in the youngest and a direct association in the oldest, for both sexes, but significant only between deprived and affluent in older ages (≥75years). Conclusions:Interaction between SES and age may be due to inequalities in lifestyles, access to health systems and preventive actions. These results may help decision-makers to better understand the epidemiology of hip fractures and to better direct the available funding.

show abstract

Section: Discussionmentioning

confidence: 99%

The interactions between municipal socioeconomic status and age on hip fracture risk

et al. 2014

View full text Add to dashboard Cite

show abstract

“…We identified eligible papers for the following 14 countries: Austria 9 , Denmark 17 , Estonia 24 , Finland 7 , France 25 , Germany 12 , Italy 26 , the Netherlands 27 , Norway 28 , Portugal 29 , Spain 30 , Sweden 31 , Switzerland 18 , and the UK – England 32 . Series differed between countries in time span, periodicity and age groups considered, but no data imputation was conducted (Table 1).…”

Section: Methodsmentioning

confidence: 99%

Quantitative modelling of hip fracture trends in 14 European countries: testing variations of a shared reversal over time

Lucas

Martins

Severo

et al. 2017

Sci Rep

View full text Add to dashboard Cite

Qualitative similarities between hip fracture trends in different countries suggests variations of the same epidemic. We tested a single statistical shape to describe time trends in Europe, while allowing for country-level variability. Using data from 14 countries, we modelled incidence rates over time using linear mixed-effects models, including the fixed effects of calendar year and age. Random effects were tested to quantify country-level variability in background rates, timing of trend reversal and tempo of reversal. Mixture models were applied to identify clusters of countries defined by common behavioural features. A quadratic function of time, with random effects for background rates and timing of trend reversal, adjusted well to the observed data. Predicted trend reversal occurred on average in 1999 in women (peak incidence about 600 per 100 000) and 2000 in men (about 300 per 100 000). Mixture modelling of country-level effects suggested three clusters for women and two for men. In both sexes, Scandinavia showed higher rates but earlier trend reversals, whereas later trend reversals but lower peak incidences were found in Southern Europe and most of Central Europe. Our finding of a similar overall reversal pattern suggests that different countries show variations of a shared hip fracture epidemic.

show abstract

“…This decrease could be the result of one or several factors mentioned in other studies (medication, prevention, changes in risk factors or changes in the codification system) [16]. However, the most plausible reason for the different period effect for men and women has been discussed in a previous study with the same population [15] where we identified a relationship between the number of anti-osteoporotic medication sales with the pattern of age-standardised incidence rates in women-the target population of the prescriptions. The current results confirm the existence of period effects even after adjusting for age and cohort effects.…”

Section: Discussionmentioning

confidence: 90%

“…Following that year, a sharp decrease was observed compatible with an increase in sales of anti-osteoporotic medication packages. In men, no such pattern was identified [15]. However, alterations in the prevalence of risk factors such as nutrition, smoking, alcohol or obesity can also be seen as period effects [16].…”

Section: Introductionmentioning

confidence: 99%

Age–period–cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in risk

et al. 2013

View full text Add to dashboard Cite

Summary An age-period cohort model was fitted to analyse time effects on hip fracture incidence rates by sex (Portugal, 2000(Portugal, -2008. Rates increased exponentially with age (age effect). Incidence rates decreased after 2004 for women and were random for men (period effect). New but comprehensive fluctuations in risk were coincident with major political/economic changes (cohort effect).Introduction Healthcare improvements have allowed preven-tion but have also increased life expectancy, resulting in more people being at risk. Our aim was to analyse the separate effects of age, period and cohort on incidence rates by sex in Portugal, 2000Portugal, -2008 Methods From the National Hospital Discharge Register, we selected admissions (aged ≥49 years) with hip fractures (ICD9-CM, codes 820.x) caused by low/moderate trauma (falls from standing height or less), readmissions and bone cancer cases. We calculated person-years at risk using population data from Statistics Portugal. To identify period and cohort effects for all ages,we usedanage-period-cohort model (1-year in-tervals) followed by generalised additive models with a negative binomial distribution of the observed incidence rates of hip fractures. Results There were 77,083 hospital admissions (77.4 % women). Incidence rates increased exponentially with age for both sexes (age effect). Incidence rates fell after 2004 for women and were random for men (period effect). There was a general cohort effect similar in both sexes; risk of hip fracture altered from an increas-ing trend for those born before 1930 to a decreasing trend following that year. Risk alterations (not statistically significant) coincident with major political and economic change in the history of Portugal were observed around birth cohorts 1920 (stable-increasing), 1940 (decreasing-increasing) and 1950 (in-creasing-decreasing only among women). Conclusions Hip fracture risk was higher for those born dur-ing major economically/politically unstable periods. Although bone quality reflects lifetime exposure, conditions at birth may determine future risk for hip fractures.

show abstract

Osteoporotic hip fractures: Bisphosphonates sales and observed turning point in trend. A population-based retrospective study

Cited by 20 publications

References 18 publications

The interactions between municipal socioeconomic status and age on hip fracture risk

The interactions between municipal socioeconomic status and age on hip fracture risk

Quantitative modelling of hip fracture trends in 14 European countries: testing variations of a shared reversal over time

Age–period–cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in risk

Contact Info

Product

Resources

About