Lee Euni, Zuckerman Ilene H, Weiss Sheila R
Department of Clinical and Administrative Pharmacy Sciences, School of Pharmacy, Howard University, 2300 Fourth St, NW, Washington, DC 20059, USA.
Arch Intern Med. 2002 Nov 11;162(20):2362-6. doi: 10.1001/archinte.162.20.2362.
Women experience rapid bone loss following menopause. Currently available guidelines recommend lifestyle counseling and pharmacotherapy for osteoporosis prevention and treatment in postmenopausal women.
We analyzed 2 years of National Ambulatory Medical Care Survey data (1997-1998), a national representative survey evaluating recent national patterns of antiosteoporosis medication (AOM) use and lifestyle counseling among office visits made by nonpregnant women 40 years and older.
Women 40 years and older made an estimated 267 million office visits annually. Of those visits, about 10% were associated with AOM therapy. Estrogen replacement therapy was the most prevalent form of AOM therapy (80%) followed by therapy with calcium and/or cholecalciferol (vitamin D) supplements (15%). Visits for AOM were more likely to be associated with women in their 50s and 60s, white race, and having private insurance or Medicare. Women at AOM visits were twice as likely to receive concurrent lifestyle counseling than women at visits without AOM therapy.
Women are particularly at risk for osteoporosis as they experience menopause, with estimates of 20 million women with osteoporosis or osteopenia. Despite the high prevalence, our study showed that only 10% of all visits were associated with 1 or more AOM therapy prescribed, provided, or continued in 1997 and 1998. These data also suggest that women with Medicaid or self-pay status were less likely to receive AOMs than women with other forms of insurance. The status of AOM therapy and lifestyle counseling in ambulatory care practice in the United States during 1997 and 1998 was less than optimal.
女性在绝经后会经历快速的骨质流失。目前可用的指南推荐通过生活方式咨询和药物治疗来预防和治疗绝经后女性的骨质疏松症。
我们分析了两年的国家门诊医疗调查数据（1997 - 1998年），这是一项具有全国代表性的调查，评估了40岁及以上非妊娠女性在门诊就诊时使用抗骨质疏松药物（AOM）和生活方式咨询的近期全国模式。
40岁及以上的女性每年估计有2.67亿次门诊就诊。在这些就诊中，约10%与AOM治疗相关。雌激素替代疗法是AOM治疗中最常见的形式（80%），其次是钙和/或胆钙化醇（维生素D）补充剂治疗（15%）。AOM就诊更有可能与50多岁和60多岁的女性、白人以及拥有私人保险或医疗保险的女性相关。接受AOM治疗的女性同时接受生活方式咨询的可能性是未接受AOM治疗女性的两倍。
女性在绝经时尤其易患骨质疏松症，估计有2000万女性患有骨质疏松症或骨质减少症。尽管患病率很高，但我们的研究表明，在1997年和1998年，所有就诊中只有10%与开具、提供或持续使用一种或多种AOM治疗相关。这些数据还表明，与拥有其他形式保险的女性相比，拥有医疗补助或自费身份的女性接受AOM治疗的可能性较小。1997年和1998年美国门诊护理实践中AOM治疗和生活方式咨询的状况不尽人意。
