Regional differences in treatment for osteoporosis. The Global Longitudinal Study of Osteoporosis in Women (GLOW) Academic Article uri icon

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abstract

  • PURPOSE: To determine if important geographic differences exist in treatment rates for osteoporosis and whether this variation can be explained by regional variation in risk factors. METHODS: The Global Longitudinal Study of Osteoporosis in Women is an observational study of women ≥55 years sampled from primary care practices in 10 countries. Self-administered questionnaires were used to collect data on patient characteristics, risk factors for fracture, previous fractures, anti-osteoporosis medication, and health status. RESULTS: Among 58,009 women, current anti-osteoporosis medication use was lowest in Northern Europe (16%) and highest in U.S.A. and Australia (32%). Between 48% (U.S.A., Southern Europe) and 68% (Northern Europe) of women aged ≥65 years with a history of spine or hip fracture since age 45 were untreated. Among women with osteoporosis, the percentage of treated cases was lowest in Europe (45-52% versus 62-65% elsewhere). Women with osteopenia and no other risk factors were treated with anti-osteoporosis medication most frequently in U.S.A. (31%) and Canada (31%), and least frequently in Southern Europe (12%), Northern Europe (13%), and Australia (16%). After adjusting for risk factors, U.S. women were threefold as likely to be treated with anti-osteoporosis medication as Northern European women (odds ratio 2.8; 95% confidence interval 2.5-3.1) and 1.5 times as likely to be treated as Southern European women (1.5, 1.4-1.6). Up to half of women reporting previous hip or spine fracture did not receive treatment. CONCLUSIONS: The likelihood of being treated for osteoporosis differed between regions, and cannot be explained by variation in risk factors. Many women at risk of fracture do not receive prophylaxis.

authors

  • Díez-Pérez, Adolfo
  • Hooven, Frederick H
  • Adachi, Jonathan Derrick
  • Adami, Silvano
  • Anderson, Frederick A
  • Boonen, Steven
  • Chapurlat, Roland
  • Compston, Juliet E
  • Cooper, Cyrus
  • Delmas, Pierre
  • Greenspan, Susan L
  • LaCroix, Andrea Z
  • Lindsay, Robert
  • Netelenbos, J Coen
  • Pfeilschifter, Johannes
  • Roux, Christian
  • Saag, Kenneth G
  • Sambrook, Philip
  • Silverman, Stuart
  • Siris, Ethel S
  • Watts, Nelson B
  • Nika, Grigor
  • Gehlbach, Stephen H

publication date

  • September 2011

published in