Literature DB >> 15883628

Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong?

Susan B Jaglal1, Iris Weller, Muhammad Mamdani, Gillian Hawker, Hans Kreder, Liisa Jaakkimainen, Jonathan D Adachi.   

Abstract

UNLABELLED: A worldwide epidemic of hip fractures has been predicted. Time trends in BMD testing, bone-sparing medications and hip and wrist fractures in the province of Ontario, Canada, were examined. From 1996 to 2001, BMD testing and use of bone-sparing medications increased each year, whereas despite the aging of the population, wrist and hip fracture rates decreased.
INTRODUCTION: If patients with osteoporosis are being diagnosed and effective treatments used with increasing frequency in the population, rates of hip and wrist fractures will remain stable or possibly decrease. We report here time trends in BMD testing, prescriptions for bone-sparing medications, hip and wrist fracture rates, and population projections of fracture rates to 2005 in the province of Ontario, Canada.
MATERIALS AND METHODS: Ontario residents have universal access to Medicare. To examine time trends in BMD testing, all physician claims for DXA from 1992 to 2001 were selected from the Ontario Health Insurance Plan (OHIP) database. Trends in prescribing were examined from 1996 to 2003 using data from the Ontario Drug Benefit plan, which provides coverage to persons > or = 65 years of age. Actual numbers of hip and wrist fractures were determined for 1992-2000 and population projections for 2001-2005 using time-series analysis. Wrist fractures were identified in the OHIP database and hip fractures through hospital discharge abstracts.
RESULTS: From 1992 to 2001, the number of BMD tests increased 10-fold. There has been a steady increase in the number of persons filling prescriptions for antiresorptives (12,298 in 1996 to 225,580 in 2003) and the majority were for etidronate. For women, the rate of decline for wrist fractures is greater than that for hip fractures. The rate of hip fracture was fairly constant around 41 per 10,000 women > or = 50 years between 1992 and 1996. In 1997, the hip fracture rate began to decrease, and the population projections suggest that this downward trend will continue to a rate of 33.1 per 10,000 in 2005.
CONCLUSIONS: Our findings suggest that fracture rates may be on the decline, despite the aging of the population, because of increased patterns of diagnosis and treatment for osteoporosis.

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Year:  2004        PMID: 15883628     DOI: 10.1359/JBMR.041231

Source DB:  PubMed          Journal:  J Bone Miner Res        ISSN: 0884-0431            Impact factor:   6.741


  88 in total

1.  Epidemiology of hip fractures in Austria: evidence for a change in the secular trend.

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2.  Femoral fractures in the extremely elderly.

Authors:  Giulio Guido; Stefano Giannotti; Vanna Bottai; Marco Ghilardi; Maria Giulia Bianchi; Michael James Ceglia
Journal:  Clin Cases Miner Bone Metab       Date:  2011-05

3.  Discrepancies in national incidence trends for hip fracture: why does Austria have such a high incidence?

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5.  Re: The perspective of the International Osteoporosis Foundation on the official positions of the International Society for Clinical Densitometry.

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Journal:  Osteoporos Int       Date:  2006       Impact factor: 4.507

6.  Impact of increased overweight on the projected prevalence of osteoporosis in older women.

Authors:  A C Looker; K M Flegal; L J Melton
Journal:  Osteoporos Int       Date:  2006-10-20       Impact factor: 4.507

7.  Bone mineral density measurement in puerperal women as a predictor of persistent osteopenia.

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Journal:  J Bone Miner Metab       Date:  2009-01-27       Impact factor: 2.626

8.  Osteoporosis practice patterns in 2006 among primary care physicians participating in the NORA study.

Authors:  T W Weiss; E S Siris; E Barrett-Connor; P D Miller; C A McHorney
Journal:  Osteoporos Int       Date:  2007-06-19       Impact factor: 4.507

9.  Injury due to mechanical falls: future directions in gender-specific surveillance, screening, and interventions in emergency department patients.

Authors:  Marna R Greenberg; Bryan G Kane; Vicken Y Totten; Neha P Raukar; Elizabeth C Moore; Tracy Sanson; Robert D Barraco; Michael C Nguyen; Federico E Vaca
Journal:  Acad Emerg Med       Date:  2014-12       Impact factor: 3.451

10.  Unchanging incidence of hip fracture in southeastern norway.

Authors:  Sam Polesie; Ulf Sigurdsen; Kristian Bjørgul
Journal:  Geriatr Orthop Surg Rehabil       Date:  2013-06
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