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Osteoporos Int. 2009 Feb;20(2):299-307. doi: 10.1007/s00198-008-0651-x. Epub 2008 Jun 13.

Initiation of anti-osteoporotic therapy in patients with recent fractures: a nationwide analysis of prescription rates and persistence.

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1
Department of Internal Medicine, Copenhagen University Hospital Gentofte, Hellerup, Denmark.

Abstract

Initiation and compliance with anti-osteoporotic therapy was assessed in 152,777 fracture patients in a national population-based cohort study. Prescription rates were low, especially following hip fracture. Persistence has improved with almost 2/3 of patients who began raloxifene or weekly alendronate obtaining treatment durations equalling those of the licensing trials.

INTRODUCTION:

Reducing the societal fracture burden remains challenging due to failure to treat fragility fractures and non-compliance with treatment.

METHODS:

We used national registers to identify patients born 1945 or earlier who sustained a fracture 1997-2004 (N = 152,777). Initiation of anti-osteoporotic therapy was defined as redemption of at least one prescription in the year following fracture. Persistence was defined as duration of time maintaining a medication possession ratio >75%.

RESULTS:

Treatment initiation within 1 year was highest after spine fracture: 39.6% of women began therapy in 2004 compared with 19.5% in 1997. In men, 16.5% began therapy in 2004 vs. 8.0% in 1997. Following hip fracture, 9.2% of women and 4.1% of men began therapy in 2004 vs. 3.4% and 0.7% in 1997, respectively. Median persistence (years) was 2.8 for daily alendronate, 3.8 for weekly alendronate, 2.5 for etidronate and 4.7 for raloxifene. The risk of discontinuing or changing therapy increased with age.

CONCLUSIONS:

Prescription rates for anti-osteoporotic medication are very low, especially in hip fracture and in men. Rates were <1/3 of those reported in the US. Persistence has improved with almost 2/3 of patients who began raloxifene or weekly alendronate now obtaining treatment durations equalling those of the licensing trials.

PMID:
18551241
DOI:
10.1007/s00198-008-0651-x
[Indexed for MEDLINE]

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