Treatment of osteoporosis in an older home care population

TitleTreatment of osteoporosis in an older home care population
Publication TypeJournal Article
Year of Publication2005
AuthorsVik SA, Maxwell CJ, Hanley DA
JournalBMC musculoskeletal disorders
Keywords*Home Care Services/sn [Statistics & Numerical Data], *Home Care Services/st [Standards], *Osteoporosis/dt [Drug Therapy], *Quality of Health Care, Aged, Canada/ep [Epidemiology], Female, Fractures, Bone/ep [Epidemiology], Health Services Accessibility, Humans, Longitudinal Studies, Male, Osteoporosis/ep [Epidemiology], Prevalence

BACKGROUND: 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., METHODS: 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., RESULTS: 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., CONCLUSIONS: 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.