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BMC Musculoskeletal Disorders

, 6:7

First Online: 11 February 2005Received: 01 October 2004Accepted: 11 February 2005


BackgroundPrevious 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.

MethodsSubjects 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.

ResultsOf 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.

ConclusionsThe 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.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-6-7 contains supplementary material, which is available to authorized users.

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Autor: Shelly A Vik - Colleen J Maxwell - David A Hanley


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