Wang Chi-Chuan, Wu Chung-Hsuen, Farley Joel F
National Taiwan University, Taipei, Taiwan
Taipei Medical University, Taipei, Taiwan.
Ann Pharmacother. 2015 Sep;49(9):995-1003. doi: 10.1177/1060028015588127. Epub 2015 Jun 3.
Whereas the National Osteoporosis Foundation (NOF) guidelines suggest pharmacological treatment for patients at high risk of fractures, little is known about the prevalence of osteoporosis treatment among those who met the NOF criteria for pharmacotherapy.
To evaluate the prevalence of osteoporosis treatment among patients who met the NOF criteria and to assess factors associated with pharmacological treatment.
The 2005-2010 National Health and Nutrition Examination Survey served as the data source. Using the Fracture Risk Assessment Tool, the study included postmenopausal women and men 50 years or older who met the NOF treatment criteria. Andersen's Behavioral Model was used to select predisposing, enabling, and need factors that might predict osteoporosis treatment. A logistic regression was used to assess factors associated with osteoporosis treatment.
An estimated 16 million individuals qualified for osteoporosis treatment according to the NOF guidelines. Only 24% of them received pharmacological treatment, and 89% of the patients receiving treatment were women. Only 6% to 12% of men who were at high risk of osteoporosis or fracture received pharmacotherapy. Older age, long-term corticosteroid use, history of fractures, and T-score ≤-2.5 were associated with increased odds of osteoporosis treatment, whereas male gender and lack of a usual source of health care were associated with decreased odds of osteoporosis treatment.
Less than one-fourth of the population who should be considered for pharmacotherapy received osteoporosis treatment. Clinicians should be more aware of the unmet need for medication treatment for osteoporosis.
尽管美国国家骨质疏松基金会(NOF)指南建议对骨折高危患者进行药物治疗,但对于符合NOF药物治疗标准的人群中骨质疏松治疗的患病率知之甚少。
评估符合NOF标准的患者中骨质疏松治疗的患病率,并评估与药物治疗相关的因素。
2005 - 2010年国家健康与营养检查调查作为数据源。使用骨折风险评估工具,该研究纳入了符合NOF治疗标准的50岁及以上绝经后女性和男性。采用安德森行为模型来选择可能预测骨质疏松治疗的易患因素、促成因素和需求因素。使用逻辑回归评估与骨质疏松治疗相关的因素。
根据NOF指南,估计有1600万人符合骨质疏松治疗条件。其中只有24%接受了药物治疗,接受治疗的患者中89%为女性。骨质疏松或骨折高危男性中只有6%至12%接受了药物治疗。年龄较大、长期使用皮质类固醇、有骨折史以及T值≤ - 2.5与骨质疏松治疗几率增加相关,而男性性别和缺乏常规医疗保健来源与骨质疏松治疗几率降低相关。
应考虑药物治疗的人群中,不到四分之一接受了骨质疏松治疗。临床医生应更加意识到骨质疏松药物治疗未满足的需求。