Affiliation:
1. The Ohio State University Wexner Medical Center, Columbus, USA
Abstract
Purpose: To understand national trends and costs associated with the utilization of anti-osteoporotic medication and DEXA screening within the year following a sentinel/primary distal radius fracture. Methods: The 2008-2015Q1 Humana Administrative Claims database was queried to identify patients aged ≥50 years, with a “sentinel” occurrence of a primary closed distal radius fracture. Linear regression models were used to report and assess for significant trends in utilization of anti-osteoporotic medication and DEXA screenings within the year following the fracture. Multivariate logistic regression analyses were used to assess for factors associated with receiving or not receiving anti-osteoporotic medication. Results: A total of 14 526 sentinel distal radius fractures were included in the study. Only 7.2% (n = 1046) of patients received anti-osteoporosis medication in the year following the distal radius fracture. Treatment with medication for osteoporosis declined from 8.2% in 2008 to 5.9% in 2015, whereas the rate of DEXA screening increased from 14.8% in 2008 to 23.6% in 2015. The most common prescribed treatment was alendronate sodium (n = 835; 79.8%—$49/patient). Factors associated with increased odds of receiving anti-osteoporotic medication were age 70 to 79 years (odds ratio [OR], 1.45; P = .014), age 80 to 89 years (OR, 1.66; P = .001), Asian (OR, 2.95; P = .002) or Hispanic (OR, 1.77; P = .006) ethnicity, belonging to South (OR, 1.19; P = .029) or West (OR, 1.37; P = .010), and having an Elixhauser Comorbidity Index score of 3 (OR, 2.14; P = .024) or > 3 (OR, 2.05; P = .022). Conclusions: Despite a rising utilization of DEXA screening following “sentinel” distal radius fractures, the proportion of individuals who receive anti-osteoporotic treatment is decreasing over time.
Subject
Orthopedics and Sports Medicine,Surgery
Reference40 articles.
1. Osteoporosis: A still increasing prevalence
2. Porter JL, Varacallo M. StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/28722930. Published 2020. Accessed June 14, 2020.
3. International Osteoporosis Foundation. Key Statistics for North America. https://www.iofbonehealth.org/facts-statistics#category-23. Published 2017. Accessed April 26, 2020.
4. Diagnosis and Treatment of Osteoporosis Before and After Fracture: A Side-by-Side Analysis of Commercially Insured and Medicare Advantage Osteoporosis Patients
5. The Epidemiology of Distal Radius Fractures