IQVIA, Plymouth Meeting, PA, USA.
Amgen Inc., Thousand Oaks, CA, USA.
Arch Osteoporos. 2022 Jul 14;17(1):92. doi: 10.1007/s11657-022-01135-4.
Among women ≥ 50 years with fracture, 76% had not received osteoporosis diagnosis or treatment at 6 months and only 14% underwent a DXA scan. Nearly half of all and 90% of hip fracture patients required surgery. Fractures cause substantial clinical burden and are not linked to osteoporosis diagnosis or treatment.
Osteoporosis (OP) and OP-related fractures are a major public health concern, associated with significant economic burden. This study describes management patterns following a nontraumatic fracture for commercially insured patients.
This retrospective cohort study identified women aged ≥ 50 years having their first nontraumatic index fracture (IF) between January 1, 2015 and June 30, 2019, from IQVIA's PharMetrics® Plus claims database. Medical management patterns at month 6 and medication use patterns at months 6, 12, and 24 following the IF were described.
Among 48,939 women (mean (SD) age: 62.7 (9.5) years), the most common fracture types were vertebral (30.6%), radius/ulna (24.9%), and hip (HF; 12.1%). By month 6, 76% of patients had not received an OP diagnosis or treatment, 13.6% underwent a DXA scan, and 11.2% received any OP treatment. Surgery was required in 43.1% of all patients and 90.0% of HF patients on or within 6 months of the fracture date. Among HF patients, 41.4% were admitted to a skilled nursing facility, 96.7% were hospitalized an average of 5.5 days, and 38.1% required durable medical equipment use. The 30-day all-cause readmission rate was 14.3% among those hospitalized for the IF. Overall, 7.4%, 9.9%, and 13.2% had a subsequent fracture at months 6, 12, and 24, respectively.
Our findings provide an overview of post-fracture management patterns using real-world data. OP was remarkably underdiagnosed and undertreated following the initial fracture. Nontraumatic fracture, particularly HF, resulted in substantial ongoing clinical burden.
在≥50 岁的女性骨折患者中，有 76%在 6 个月时未被诊断为骨质疏松症或接受治疗，仅有 14%接受了 DXA 扫描。几乎所有（43.1%）和 90%（90.0%）的髋部骨折患者需要手术。骨折导致了巨大的临床负担，且与骨质疏松症的诊断或治疗无关。
骨质疏松症（OP）和与 OP 相关的骨折是一个主要的公共卫生问题，与巨大的经济负担相关。本研究描述了商业保险患者发生非外伤性骨折后的管理模式。
这项回顾性队列研究从 IQVIA PharMetrics® Plus 索赔数据库中确定了 2015 年 1 月 1 日至 2019 年 6 月 30 日期间首次发生非外伤性指数骨折（IF）的年龄≥50 岁的女性。描述了第 6 个月的医疗管理模式和第 6、12 和 24 个月的药物使用模式。
在 48939 名女性（平均（SD）年龄：62.7（9.5）岁）中，最常见的骨折类型为椎体（30.6%）、桡骨/尺骨（24.9%）和髋部（HF；12.1%）。到第 6 个月，76%的患者未被诊断为 OP 或接受治疗，13.6%接受了 DXA 扫描，11.2%接受了任何 OP 治疗。所有患者中有 43.1%需要手术，HF 患者中有 90.0%在骨折日期后的 6 个月内接受了手术。在 HF 患者中，41.4%入住了康复护理院，96.7%平均住院 5.5 天，38.1%需要使用耐用医疗设备。因 IF 住院的患者中有 14.3%在 30 天内再次因任何原因入院。总体而言，第 6、12 和 24 个月时分别有 7.4%、9.9%和 13.2%的患者发生了后续骨折。
我们的研究结果提供了使用真实世界数据的骨折后管理模式概述。OP 在初始骨折后明显被漏诊和治疗不足。非外伤性骨折，特别是 HF，导致了巨大的持续临床负担。
