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Bone. 2019 Oct 5:115071. doi: 10.1016/j.bone.2019.115071. [Epub ahead of print]

Mind the gap: Incidence of osteoporosis treatment after an osteoporotic fracture - Results of the Austrian branch of the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS).

Author information

1
Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria. Electronic address: oliver.malle@medunigraz.at.
2
Karolinska Institutet, Dept. of Learning, Informatics, Management and Ethics, Stockholm, Sweden.
3
Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Graz, Austria.
4
MAPI Group, Real World Strategy and Analytics, Stockholm, Sweden.
5
Medical Faculty, Heinrich Heine University, Duesseldorf, Germany.

Abstract

INTRODUCTION:

Despite availability of effective treatment options proven to prevent osteoporotic fractures, a huge gap in osteoporosis treatment exists. The aim of the present study was to evaluate the treatment rate after a major osteoporotic fracture (MOF) in Austria, one of the 25 wealthiest countries worldwide.

METHODS:

This analysis is based on the data of the International Costs and Utilities Related to Osteoporotic Fractures Study (ICUROS), a prospective observational study assessing data from patients who suffered a MOF. We stratified these patients by treatment status at time of fracture and compared treatment use following MOF by sex as well as by fracture sites at the time of the index fracture, and 4, 12, and 18 months thereafter. Descriptive statistics, t-tests for continuous variables and chi-squared tests for nominal variables, were performed to compare treatment groups.

RESULTS:

A total of 915 patients (78% female) were recruited at 8 different trauma centers throughout Austria. At the time of fracture, 731 patients (80%) did not receive osteoporosis treatment. In this group, follow-up analysis after 4, 12 and 18 months revealed a treatment rate of 18%, 16%, 15% in women, and 8%, 12%, 10% in men, respectively. In those who received osteoporosis medication at the time of fracture the treatment rate was 65%, 54% and 60% in women, and comparable results in men.

CONCLUSIONS:

Only 1 in 10 men, and <2 in 10 women of those who did not receive osteoporosis treatment at the time of fracture were prescribed an adequate osteoporosis treatment. Thus, the vast majority of patients who sustained an osteoporotic fracture and thus were at imminent risk of receiving subsequent fractures did not receive an adequate treatment. There is a clear need for the implementation of coordinated, multi-disciplinary models of care for secondary fracture prevention.

MINI ABSTRACT:

Despite availability of effective treatment to prevent osteoporotic fractures, the vast majority of patients in Austria, who sustained an osteoporotic fracture, do not receive an adequate osteoporosis treatment.

KEYWORDS:

Austria; Fractures; Gap; Osteoporosis; Prevention; Treatment

PMID:
31593822
DOI:
10.1016/j.bone.2019.115071
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