Pattern of osteoporosis prevalence and associated medication use among Australian women over two decades. — ASN Events
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Pattern of osteoporosis prevalence and associated medication use among Australian women over two decades. (#207)

Amanda L Stuart 1 , Julie A Pasco 1 2 3 , Mohammadreza Mohebbi 4 , Mark A Kotowicz 1 3 , Lana J Williams 1
  1. Deakin University, IMPACT SRC, Geelong, VIC, Australia
  2. Melbourne Medical School-Western Campus, The University of Melbourne, St Albans, Victoria, Australia
  3. Barwon Health, Geelong, Victoria, Australia
  4. Faculty of Health, Deakin University, Burwood, Victoria, Australia

Background:  Osteoporosis is characterized by low bone mineral density and an increased fracture risk. Despite the burden of osteoporosis, treatment rates have been low. We aimed to examine trends in the prevalence of osteoporosis and associated medication use over time using prospective data from the Geelong Osteoporosis Study.

 

Methods: Of 1,494 women (aged 20-85yr) recruited 1993-1997 (Time-1), self-reported medication use data reported for 2004-2008 (Time-2) and/or 2011-2014 (Time-3) were available for 913 women. Prevalence of osteoporosis (T score <-2.5 at femoral neck or spine) and osteoporosis-related medication use [anti-fracture (bisphosphonates, selective estrogen receptor modulators); hormone replacement therapy (HRT); and supplements (calcium and vitamin D)] were calculated using bootstrapping methods. Cohort (age groups 20-39.9, 40-59.9, 60+yr) and time-point effects were evaluated using Pearson’s Chi square and logistic regression.

 

Results: The prevalence of osteoporosis increased over time; Time-1: 6.9% (95%CI 5.4-8.8), Time-2: 8.7% (95%CI 6.8-10.6) and Time-3: 8.0% (95%CI 5.8-10.0), age adjusted p<0.001. Use of any osteoporosis-related medication also increased [Time-1: 22.0% (95%CI 19.5, 25.0), Time-2: 24.4% (95%CI 21.4, 27.4), Time-3: 27.7% (95%CI 24.3, 31.2), p=0.002]. A higher proportion of women aged 60+yr used osteoporosis-related medication at each time point (p=0.002).

Among women with osteoporosis on bone density criteria, use of anti-fracture medication was low [Time-1: 1.6% (95%CI 0.0, 5.6), Time-2: 20.2% (95%CI 11.6, 28.9), Time-3: 15.5% (95%CI 6.9, 25.0)], and supplement use was moderate [Time-1: 17.5% (95%CI 8.8, 27.2), Time-2: 47.2% (95%CI 36.3, 58.6), Time-3: 41.4% (95%CI 28.6, 53.8)]. The use of HRT in this group declined over time [Time-1: 12.7% (95%CI 4.3, 22.4), Time-2: 5.6% (95%CI 1.2, 11.2), Time-3: 1.7% (95%CI 0.0, 5.5), p<0.001]. 

 

Conclusion: Use of anti-fracture medication among women with osteoporosis remained low across the study period. Investigations into treatment gap reduction is warranted.