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Osteoporosis International
Published in: Osteoporosis International 6/2019

Open Access 01-06-2019 | Glucocorticoid | Original Article

Extensive undertreatment of osteoporosis in older Swedish women

Authors: M. Lorentzon, A. G. Nilsson, H. Johansson, J. A. Kanis, D. Mellström, D. Sundh

Published in: Osteoporosis International | Issue 6/2019

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Abstract

Summary

In a population-based study of older Swedish women, we investigated the proportion of women treated with osteoporosis medication in relation to the proportion of women eligible for treatment according to national guidelines. We found that only a minority (22%) of those eligible for treatment were prescribed osteoporosis medication.

Introduction

Fracture rates increase markedly in old age and the incidence of hip fracture in Swedish women is among the highest in the world. Although effective pharmacological treatment is available, treatment rates remain low. Limited data are available regarding treatment rates in relation to fracture risk in a population-based setting in older women. Therefore, we aimed to investigate the proportion of older women eligible for treatment according to Swedish Osteoporosis Society (SvOS) guidelines.

Methods

A population-based study was performed in Gothenburg in 3028 older women (77.8 ± 1.6 years [mean ± SD]). Bone mineral density of the spine and hip was measured with dual-energy X-ray absorptiometry. Clinical risk factors for fracture and data regarding osteoporosis medication was collected with self-administered questionnaires. Logistic regression was used to evaluate whether the 10-year probability of sustaining a major osteoporotic fracture (FRAX-score) or its components predicted treatment with osteoporosis medication.

Results

For the 2983 women with complete data, 1107 (37%) women were eligible for treatment using SvOS criteria. The proportion of these women receiving treatment was 21.8%. For women eligible for treatment according to SvOS guidelines, strong predictors for receiving osteoporosis medication were glucocorticoid treatment (odds ratio (95% CI) 2.88 (1.80–4.59)) and prior fracture (2.58 (1.84–3.61)).

Conclusion

This study demonstrates that a substantial proportion of older Swedish women should be considered for osteoporosis medication given their high fracture risk, but that only a minority receives treatment.
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Metadata
Title
Extensive undertreatment of osteoporosis in older Swedish women
Authors
M. Lorentzon
A. G. Nilsson
H. Johansson
J. A. Kanis
D. Mellström
D. Sundh
Publication date
01-06-2019
Publisher
Springer London
Published in
Osteoporosis International / Issue 6/2019
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-019-04872-4

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