Osteoporosis drug use predicted by educational level
MedWire News: Use of osteoporosis drugs in the elderly is determined by level of educational attainment even where access to healthcare is equal, suggests research from Sweden.
The study, published in Osteoporosis International, also found that men were less likely to receive osteoporosis drugs than women.
"More research on socioeconomic differences in osteoporosis drug treatment, both as primary and secondary prevention, is needed to identify the underlying pathways and connections between [socioeconomic position], gender, and access to adequate treatment in one of the major geriatric diseases," report Jonas Wastesson (Karolinska Institutet & Stockholm University) and co-authors.
The researchers collated data from the Swedish Prescribed Drug Register, the Swedish Patient Register, and the Swedish Education Register for 645,429 individuals aged 75-89 years old. In particular, they recorded educational attainment, osteoporotic fractures occurring between 1998 and 2004, and prescriptions filled between July and October 2005 for antiresorptive agents, calcium/vitamin D supplements, and selective estrogen receptor modulators.
Analysis revealed that a high level of education was significantly associated with use of osteoporosis drugs for both men and women, after adjusting for age, osteoporotic fracture, and comorbidity (odds ratio [OR]=1.27 and 1.57 versus low educational attainment, respectively).
Overall, 57,613 individuals had sustained a fracture during the study period. Compared with the whole study population, patients with fractures were more likely to be female, older, and have lower educational attainment. Education attainment did not significantly predict use of osteoporosis medications in men, however.
Of note, 31% of female fracture patients received osteoporosis medications compared with just 10% of male counterparts.
Men were most likely to receive osteoporosis treatment if they sustained lumbar spine, pelvis, or femur fractures, whereas ribs/sternum/thoracic spine, and lumbar spine predicted treatment in women.
The team therefore concludes: "Uptake of osteoporosis drug therapy seems to be unequally distributed in the elderly population, even in a country with presumably equal access to health care."
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By Lynda Williams