Postmenopausal Women (04-02-2004) 

Few who suffer fractures get drug treatment to prevent further fractures

About one-fourth of women older than 50 years – most of whom are postmenopausal – suffer from osteoporosis, a loss of bone that can lead to disability, pain, deformity and fractures. Yet a new study of postmenopausal women in seven health-maintenance organizations across the United States found that only 24 percent of those who had suffered osteoporosis-related fractures received drug treatment for osteoporosis within a year following the fracture.

Richard Platt, M.D., M.S., of Harvard Pilgrim Healthcare and colleagues at the HMO Research Network Center for Education and Research in Therapeutics call for improved detection and treatment of osteoporosis in high-risk patients. These include postmenopausal women, whose low estrogen levels increase their risk of bone loss and related fracture. This research was funded in part by the Agency for Healthcare Research and Quality.

The researchers retrospectively evaluated the use of drugs recommended for preventing second fractures (estrogen replacement therapy, bisphosphonates and calcitonin) among 3,492 women aged 60 and older who were identified in a database of seven HMOs as having had a fracture of the hip, vertebra or wrist between 1994 and 1996. Of these women, only 24 percent received drugs for osteoporosis treatment during the year following the fracture.

Women who suffered vertebral fractures were twice as likely (44%) to receive medication to treat osteoporosis as those with hip (21%) or wrist (23%) fractures. Also, older women were less likely than younger women to receive osteoporosis treatment, even though aging increases the risk of fracture.

For more information, see "Low frequency of treatment of osteoporosis among postmenopausal women following a fracture," by Susan E. Andrade, Sc.D., Sumit R. Majumdar, M.D., M.P.H., K. Arnold Chan, M.D., Sc.D., et al., in the Sept. 22, 2003, issue of Archives of Internal Medicine, 163, pp. 2052-2057.