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Few postmenopausal women who have suffered a fracture receive drug treatment to prevent further fractures

About one-fourth of women older than 50 years are estimated to 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 an osteoporosis-related fracture 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 (HS10391) through the Agency's Centers for Research and Education on Therapeutics (CERTs) initiative.

The researchers retrospectively evaluated the use of drugs recommended for preventing a second fracture (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 a drug for osteoporosis treatment during the year following the fracture.

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

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., and others, in the September 22, 2003, Archives of Internal Medicine 163, pp. 2052-2057.

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