Less than one-fifth of older women in the U.S. with a hip fracture received recommended care for osteoporosis, with elderly women the least likely to receive care, researchers found.
Overall, only 17% of women, ages 50 and older, received either screening for underlying osteoporosis or evidence-based osteoporosis drug therapies within 6 months of a fracture, and only 22% were evaluated or treated for osteoporosis within the first year, reported Catherine W. Gillespie, MPH, PhD, of AARP Public Policy Institute in Washington, and Pamela E. Morin, of OptumLabs in Cambridge, Mass.
"Our study confirms prior research suggesting that few women are being evaluated or treated for osteoporosis following a hip fracture and are vulnerable to potentially preventable future bone fractures," said Lina Walker, PhD, vice president of health security at AARP's Public Policy Institute in a statement. "Addressing these missed opportunities would likely make a big difference in the survival rate and the quality of life for older women who break a hip."
Recent research suggests that rare side effects associated with osteoporosis medications have caused a drop in the number of patients willing to take these drugs.
Writing in a spotlight piece for the AARP Public Policy Institute, the authors found that elderly women (ages 80 and up) were both the least likely to receive care and at the greatest risk for recurring fractures. Women ages 80 and older were 32% less likely than women ages 50-79 to receive either screening for underlying osteoporosis or evidence-based osteoporosis drug therapies.
The researchers examined data from OptumLabs' Data Warehouse, a database of de-identified claims from a national health insurer, and followed women for an average of 2.6 years to try and identify differences in the risk of recurrent hip fractures. They found that elderly women who did not either take medication for osteoporosis or have bone density testing performed within 6 months of their first fracture were 60% more likely to experience a second fracture compared with women, ages 50-79.
"This finding could have important implications," they wrote. "It is well known that osteoporosis fracture risk increases markedly with age."
Because 10%-20% of older adults may die within a year of a hip fracture, and only 40% will return to prior levels of independence, Gillespie and Morin noted that it especially important to increase osteoporosis screening and treatment. In an upcoming study, the authors plan to identify predictors and barriers to utilization of these services, especially among elderly women.
"That work will help inform efforts to improve outcomes, especially within the age segment most susceptible to this life-altering condition," they wrote.