Aging Research Center, Karolinska Institutet & Stockholm University, Gävlegatan 16, S-113 30, Stockholm, Sweden.
Osteoporos Int. 2013 Feb;24(2):433-42. doi: 10.1007/s00198-012-1945-6. Epub 2012 Feb 21.
We examined educational disparities in use of osteoporosis drugs in a nationwide population of Swedes aged 75-89 years old. Individuals with high education were more likely to receive osteoporosis drug treatment than lower educated individuals, particularly among women.
This study aims to investigate whether educational level is associated with use of osteoporosis drugs in the general population of older men and women in Sweden, also after adjustment for fractures.
By record linkage of The Swedish Prescribed Drug Register, The Swedish Patient Register, and The Swedish Education Register, we obtained information on filling of prescriptions for osteoporosis drugs (bisphosphonates, calcium/vitamin D combinations, and selective estrogen receptor modulators) from July to October 2005, osteoporotic fractures from 1998 to 2004, and educational level for 645,429 people aged 75-89 years. Multivariate logistic regression analysis was used to investigate whether education was associated with use of osteoporosis drug therapy.
Higher education was associated with use of osteoporosis drugs for both men [odds ratio (OR)(high education vs low), 1.27; 95% confidence interval (CI), 1.19-1.35] and women (OR(high education vs low), 1.57; 95% CI, 1.52-1.61), after adjustment for age, osteoporotic fractures, and comorbidity (i.e., number of other drugs). Among those who had sustained a fracture (n = 57,613), the educational differences in osteoporosis drug treatment were more pronounced in women than men. Further, women were more likely to receive osteoporosis drug treatment after osteoporotic fracture.
Uptake of osteoporosis drug therapy seems to be unequally distributed in the elderly population, even in a country with presumably equal access to health care.
我们研究了在一个全国性的瑞典 75-89 岁年龄组人群中，教育程度对骨质疏松症药物使用的影响。高学历者比低学历者更有可能接受骨质疏松症药物治疗，尤其是女性。
本研究旨在探讨在瑞典，教育程度是否与普通老年男性和女性使用骨质疏松症药物有关，同时还考虑了骨折的影响。
通过对瑞典处方药物登记处、瑞典患者登记处和瑞典教育登记处的记录进行链接，我们获得了 2005 年 7 月至 10 月期间骨质疏松症药物（双膦酸盐、钙/维生素 D 联合制剂和选择性雌激素受体调节剂）的处方、1998 年至 2004 年期间的骨质疏松性骨折以及 645429 名 75-89 岁人群的教育水平信息。多变量逻辑回归分析用于研究教育程度与骨质疏松症药物治疗的相关性。
高学历与男性（高等教育与低等教育的比值比（OR）（1.27；95%置信区间（CI），1.19-1.35）和女性（OR（高等教育与低等教育）（1.57；95% CI，1.52-1.61）使用骨质疏松症药物治疗相关，调整了年龄、骨质疏松性骨折和合并症（即其他药物的数量）。在发生骨折的人群（n=57613）中，女性在骨质疏松症药物治疗方面的教育差异比男性更为明显。此外，女性在发生骨质疏松性骨折后更有可能接受骨质疏松症药物治疗。
即使在医疗保健可获得性大致平等的国家，骨质疏松症药物治疗的应用似乎在老年人群中分布不均。
