Osteoporosis treatment rates vary globally
MedWire News: Women in the USA are nearly three times more likely to receive osteoporosis treatment than those in Northern Europe, results from the Global Longitudinal Study of Osteoporosis in Women (GLOW) show.
Differences in the distribution of risk factors across the regions do not explain the observed differences in treatment rates, the researchers report.
Adolfo Díez-Pérez (Autonomous University of Barcelona, Spain) and colleagues used GLOW data from 58,009 women aged 55 years and older to determine whether important differences exist in rates of treatment between global regions and whether such variation can be explained by differences in risk factors.
The researchers explain that GLOW is an observational cohort study conducted at local investigation centers in 10 countries. In the present analysis the centers were grouped in into five regions, Australia, Canada, USA, Northern Europe (Belgium, Germany, Netherlands, UK), and Southern Europe (France, Italy, Spain).
Women in Northern Europe reported the lowest rate of current anti-osteoporosis medication use (16%), followed by Southern Europe (26%), Canada (31%), and the USA and Australia (both 32%).
Undertreatment was common among women aged at least 65 years with a history of spine or hip fracture; 48% of women in the USA and Southern Europe and 58% in Northern Europe were untreated, compared with 36% in Canada and 27% in Australia.
Women with an osteoporosis diagnosis in Australia, Canada, and the USA reported similar treatment rates (65%, 64%, and 62%, respectively), but the rates were lower for these women in Northern and Southern Europe (45% and 52%, respectively).
The researchers also observed cases of overtreatment among women with self-reported osteopenia and no other risk factors, with treatment rates of 31% in the USA and Canada, compared with 12%, 13%, and 16% in Southern Europe, Northern Europe, and Australia, respectively.
After adjusting for risk factors such as previous fracture and smoking, US women were 2.8 times more likely to be treated with anti-osteoporosis medication than Northern European women and 1.5 times more likely to be treated than Southern European women. In addition, Southern European women were 1.9 times more likely to be treated than Northern European women.
"The reasons for such regional variation should be explored in future studies to help guide efforts to improve consistency and effectiveness of care for osteoporosis," Díez-Pérez and co-authors conclude in the journal Bone.
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By Laura Dean