Journal article
Population-based fracture risk assessment and osteoporosis treatment disparities by race and gender
Journal of general internal medicine : JGIM, v 24(8), pp 956-962
Aug 2009
PMID: 19551449
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Undertreatment of osteoporosis has been recognized as a common problem in selected patient subgroups. However, primary prevention has been hampered by limited risk assessment tools that can be applied to large populations.
Using clinical risk factors with a new tool from the World Health Organization (FRAX) and recommendations from the National Osteoporosis Foundation (NOF), we evaluated fracture risk and osteoporosis treatment in a US cohort.
African Americans and Caucasians recruited from 2003-7 across the US as part of a longitudinal study.
Cross-sectional.
The number of persons receiving prescription osteoporosis medications was assessed by race, sex, and fracture risk. Multivariable logistic regression evaluated the association between receipt of osteoporosis medications and fracture risk after controlling for potential confounders.
Among 24,783 participants, estimated fracture risk was highest for Caucasian women. After multivariable adjustment for fracture-related risk factors, the likelihood of receipt of osteoporosis medications among African Americans was lower than among Caucasians [odds ratio (OR) = 0.44, 95% confidence interval (CI) 0.37, 0.53] and for men compared to women (OR = 0.08, 95% CI 0.06-0.10). Even for the highest risk group, Caucasian women with 10-year hip fracture risk > or = 3% (n = 3,025, 39.7%), only 26% were receiving treatment.
A substantial gap exists between 2008 NOF treatment guidelines based on fracture risk and the receipt of prescription osteoporosis medications. This gap was particularly notable for African Americans and men. FRAX is likely to be useful to assess risk at a population level and identify high-risk persons in need of additional evaluation.
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Details
- Title
- Population-based fracture risk assessment and osteoporosis treatment disparities by race and gender
- Creators
- Jeffrey R Curtis - University of Alabama at BirminghamLeslie A McClure - University of Alabama at BirminghamElizabeth Delzell - University of Alabama at BirminghamVirginia J Howard - University of Alabama at BirminghamEric Orwoll - Oregon Health & Science UniversityKenneth G Saag - University of Alabama at BirminghamMonika Safford - University of Alabama at BirminghamGeorge Howard - University of Alabama at Birmingham
- Publication Details
- Journal of general internal medicine : JGIM, v 24(8), pp 956-962
- Publisher
- Springer Nature
- Grant note
- K23 AR053351 / NIAMS NIH HHS R01 HL080477-02 / NHLBI NIH HHS R01 HL080477-03 / NHLBI NIH HHS R01 HL080477 / NHLBI NIH HHS U01 NS041588 / NINDS NIH HHS R01 HL080477-01A1 / NHLBI NIH HHS K23 AR053351-02 / NIAMS NIH HHS R01 HL080477-04 / NHLBI NIH HHS AR053351 / NIAMS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000268069500012
- Scopus ID
- 2-s2.0-77950350032
- Other Identifier
- 991019231751104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Health Care Sciences & Services