Treatment of osteoporosis in an older home care population

• Published in: BMC musculoskeletal disorders 2005-02, Vol.6 (1), p.7-7, Article 7
• Main Authors: Vik, Shelly A, Maxwell, Colleen J, Hanley, David A
• Format: Article
• Language: English
• Subjects: Aged; Canada - epidemiology; Female; Fractures, Bone - epidemiology; Health Services Accessibility; Home Care Services - standards; Home Care Services - statistics & numerical data; Humans; Longitudinal Studies; Male; Osteoporosis - drug therapy; Osteoporosis - epidemiology; Prevalence; Quality of Health Care
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/1471-2474-6-7

Previous research indicates that many patients with fractures indicative of underlying osteoporosis are not receiving appropriate diagnostic follow-up and therapy. We assessed osteoporosis treatment coverage in older home care clients with a diagnosis of osteoporosis and/or prevalent fracture. Subjects included 330 home care clients, aged 65+, participating in a longitudinal study of medication adherence and health-related outcomes. Data on clients' demographic, health and functional status and service utilization patterns were collected using the Minimum Data Set for Home Care (MDS-HC). A medication review included prescribed and over-the-counter medications taken in the past 7 days. Criteria for indications for osteoporosis therapy included diagnosis of osteoporosis or a recent fracture. Coverage for treatment was examined for anti-osteoporotic therapies approved for use in 2000. Of the 330 home care clients, 78 (24%) had a diagnosis of osteoporosis (n = 47) and/or had sustained a recent fracture (n = 34). Drug data were available for 77/78 subjects. Among the subjects with osteoporosis or a recent fracture, 45.5% were receiving treatment for osteoporosis; 14% were receiving only calcium and vitamin D, and an additional 31% were receiving drug therapy (bisphosphonate or hormone replacement therapy). The remaining 54.5% of subjects were not receiving any approved osteoporosis therapy. The high prevalence of undertreatment among a population of older adults with relatively high access to health care services raises concern regarding the adequacy of diagnosis and treatment of osteoporosis in the community.