Undertreatment of osteoporosis in regional Western Australia

Lai, Mark; Ang, Wan Mei; McGuiness, Marjory; Larke, Amanda Barbara

doi:10.1111/j.1741-6612.2011.00544.x

Cited by 18 publications

(21 citation statements)

References 14 publications

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“…We observe that more than 80% of our indigenous cohort resided outside WA metropolitan areas, a proportion in excess of what might be expected from the total Indigenous Western Australians (60.4%) living in non‐metropolitan areas . Relative underactivity of health services for the detection and management of osteoporosis has been reported in these regions, and the management rates by general medical practitioners for preventative measures among Indigenous Australians are also lower than other Australians . Our analysis of hip fracture rates stratified by area of residence suggests that only a small portion of the elevated fracture risk might be attributable to non‐metropolitan status and that the majority of the risk is attributable to other factors associated with indigenous status.…”

Section: Discussionmentioning

confidence: 99%

Hip fractures among Indigenous Western Australians from 1999 to 2009

Wong

Flicker

Draper

et al. 2013

Internal Medicine Journal

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Section: Discussionmentioning

confidence: 99%

Hip fractures among Indigenous Western Australians from 1999 to 2009

Wong

Flicker

Draper

et al. 2013

Internal Medicine Journal

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“…Study designs included 7 experimental studies and 20 observational studies [4-23]. The 27 studies were distributed in 3 themes, previously determined as follows: adherence and associated factors (20 studies) [1,2,5,7-9,11-13,15,16,18-22],[24-27], adherence and fracture (2 studies) [4,17]; adherence and dosage of BPs (5 studies) [3,6,10,14,23]. …”

Section: Resultsmentioning

confidence: 99%

“…Several studies have evaluated the association of adherence to some specific factors [2,5,15,18,21,22,24-26]. In Montori [25] and colleagues, using a prevention and treatment osteoporosis guide by patients taking BPs had no impact on adherence after 6 months, but another experimental study [24] evaluating patients taking alendronate or risedronate showed that the group which received counseling treatment had a better adherence.…”

Section: Discussionmentioning

confidence: 99%

“…In Devold [18] and colleagues, study conducted with patients taking alendronate, factors associated with adherence were advanced age and high income; in men an average educational level had the greatest impact. In the study of Lai [22] and colleagues, Australian patients who had suffered hip fractures were evaluated, 19.2% of them come from rural areas, and observed that before the fracture less rural patients used BPs (7.7% versus 13.3%) and that after fracture these patients also had lower compliance in relation to the urban group (44% versus 52.4%).…”

Section: Discussionmentioning

confidence: 99%

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Bisphosphonates adherence for treatment of osteoporosis

Vieira¹,

Leite²,

Sampaio³

et al. 2013

Int Arch Med

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BackgroundOsteoporosis is a disease of bone metabolism in which bisphosphonates (BPS) are the most common medications used in its treatment, whose main objective is to reduce the risk of fractures. The aim of this study was to conduct a systematic review on BPs adherence for treatment of osteoporosis.MethodsSystematic review of articles on BPs adherence for treatment of osteoporosis, indexed on MEDLINE (via PubMed) databases, from inception of databases until January 2013. Search terms were “Adherence, Medication” (MeSH term), “Bisphosphonates” (MeSH term), and “Osteoporosis” (MeSH term).ResultsOf the 78 identified studies, 27 met the eligibility criteria. Identified studies covered a wide range of aspects regarding adherence and associated factors, adherence and fracture, adherence and BPs dosage. The studies are mostly observational, conducted with women over 45 years old, showing low rates of adherence to treatment. Several factors may influence adherence: socio-economic and cultural, participation of physicians when guidance is given to the patient, the use of bone turnover markers, and use of generic drugs. The monthly dosage is associated with greater adherence compared to weekly dosage.ConclusionsConsidering the methodological differences between the studies, the results converge to show that adherence to treatment of osteoporosis with BPs is still inadequate. Further experimental studies are needed to evaluate the adherence and suggest new treatment options.

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“…10 In some studies, only dementia and age were independent predictors of mortality following a hip fracture. 11,12 Despite an increase in morbidity due to osteoporotic fractures, which can lead to institutionalisation, emergency admissions, physician visits and an increased inpatient length of stay (LOS), osteoporosis remains underdiagnosed 13,14 and undertreated, [15][16][17] particularly among patients with dementia, compared with those without dementia. 7,13,18 Under-treatment of osteoporosis in the elderly 19,20 contributes to significant healthcare cost burden and is predicted to rise with our ageing population.…”

mentioning

confidence: 99%

Osteoporosis in patients with dementia is associated with high morbidity and mortality: Findings from a single orthogeriatric unit

Mughal¹,

Inderjeeth²,

Inderjeeth³

2019

Aust J Gen Pract

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Background and objectives Osteoporosis and dementia are common and associated with a high healthcare burden. The aim of this paper was to assess the impact of dementia on treatment, morbidity and mortality in osteoporosis. Methods Data were collected on 502 prospective orthogeriatric admissions for fracture. Fisher's exact chi-square was used to compare treatment stratified by dementia status. Results Of the 502 patients, 281 (56%) had osteoporosis, 226 (45%) had dementia, and 156 (31%) had dementia and osteoporosis diagnosed before they sustained fractures. Patients with dementia were more likely to have osteoporosis but less likely to be receiving treatment. Although there was a significant improvement in discharge versus admission rates of osteoporosis treatment, those with dementia were less likely to be treated with antiresorptive therapy (36%, compared with 59%, P <0.001) or combined therapy (32%, compared with 56%, P <0.001) and had double the 90-day mortality (17.3%, compared with 9.6%) and six times the 30-day mortality (6.4%, compared with 1.6%). Discussion Patients with dementia and osteoporosis have a higher risk of recurrent fractures and mortality. Prevention may be the key strategy.

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Undertreatment of osteoporosis in regional Western Australia

Abstract: Undertreatment of osteoporosis was common in rural patients. These findings need to be confirmed by larger population-based studies.

Cited by 18 publications

References 14 publications

Hip fractures among Indigenous Western Australians from 1999 to 2009

Hip fractures among Indigenous Western Australians from 1999 to 2009

Bisphosphonates adherence for treatment of osteoporosis

Osteoporosis in patients with dementia is associated with high morbidity and mortality: Findings from a single orthogeriatric unit

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