University of Utah College of Pharmacy, Salt Lake, UT, USA.
Osteoporos Int. 2010 Aug;21(8):1427-36. doi: 10.1007/s00198-009-1079-7. Epub 2009 Oct 2.
We identified factors associated with oral bisphosphonate treatment in 50+-year-old female patients with a first fracture, osteoporosis diagnosis, or BMD < or =-2.5 in the Geisinger Health System electronic health record database. Treatment was positively associated with age, oral corticosteroids, and smoking, and negatively associated with body mass index and bone mineral density scores.
To identify factors associated with oral bisphosphonate treatment in patients with an indicator for post-menopausal osteoporosis.
Females age 50+ years with a first fracture, osteoporosis diagnosis, or bone mineral density (BMD) < or =-2.5 (index date) were identified in the Geisinger Health System electronic health record database. Treatment was defined as an oral bisphosphonate prescription order (risedronate sodium, ibandronate sodium, or alendronate) < or =90 days post-index date. Treatment rates were assessed and a multivariate logistic model was used to identify predictors of treatment separately for patients with fracture (FRAC) and with diagnosis or low BMD (ICD-9-BMD).
The FRAC group had 2,003 female patients with a mean (SD) age of 69.0 (+/-11.3) years and the ICD-9-BMD group had 12,976 female patients with a mean (SD) age of 66.9 (+/-10.0) years. Within 90 days of the index date of fracture, diagnosis, or low BMD score, 188 (9.4%) patients in the FRAC group and 5,395 (41.6%) in the ICD-9-BMD group received treatment. Treatment was positively associated with age and oral corticosteroids and negatively associated with body mass index and subsequent BMD in both groups. Smoking currently was positively associated with treatment in the ICD-9-BMD group.
Certain patient characteristics are predictors of physicians prescribing oral bisphosphonates. However, many patients remain untreated.
我们在 Geisinger 健康系统电子病历数据库中，确定了与 50 岁以上女性初次骨折、骨质疏松症诊断或 BMD＜-2.5 相关的口服双膦酸盐治疗因素。治疗与年龄、口服皮质类固醇和吸烟呈正相关，与体重指数和骨密度评分呈负相关。
为了确定与绝经后骨质疏松症指标相关的患者口服双膦酸盐治疗的因素。
在 Geisinger 健康系统电子病历数据库中，确定了年龄在 50 岁以上、初次骨折、骨质疏松症诊断或骨密度（BMD）＜-2.5（索引日期）的女性。治疗定义为口服双膦酸盐处方（利塞膦酸钠、伊班膦酸钠或阿仑膦酸钠）＜-90 天。评估治疗率，并使用多变量逻辑模型分别为骨折（FRAC）和诊断或低 BMD（ICD-9-BMD）患者识别治疗的预测因素。
FRAC 组有 2003 名女性患者，平均（SD）年龄为 69.0（+/-11.3）岁，ICD-9-BMD 组有 12976 名女性患者，平均（SD）年龄为 66.9（+/-10.0）岁。在骨折、诊断或低 BMD 评分的索引日期后 90 天内，FRAC 组有 188 名（9.4%）患者和 ICD-9-BMD 组有 5395 名（41.6%）患者接受治疗。在两组中，治疗与年龄和口服皮质类固醇呈正相关，与体重指数和随后的 BMD 呈负相关。目前吸烟与 ICD-9-BMD 组的治疗呈正相关。
某些患者特征是医生开具口服双膦酸盐的预测因素。然而，许多患者仍未接受治疗。
