Jones Alicia R, Enticott Joanne E, Ebeling Peter R, Mishra Gita D, Teede Helena J, Vincent Amanda J
Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia, 3168.
Department of Endocrinology, Monash Health, Melbourne, Australia, 3168.
J Endocr Soc. 2024 Jul 9;8(8):bvae127. doi: 10.1210/jendso/bvae127. eCollection 2024 Jul 1.
Osteoporosis affects more than half of older women, but many are not treated. Whether treatment differs between rural and urban areas is unknown.
To examine differences in osteoporosis treatment among postmenopausal women living in urban and rural areas of Australia.
Women participating in the Australian Longitudinal Study on Women's Health, a prospective longitudinal cohort study, born between 1946-1951, and with osteoporosis or fractures, were included. Surveys from 2004 to 2019 were linked to the Pharmaceutical Benefits Scheme (government-subsidized medications) to assess osteoporosis treatment and adherence, comparing geographical areas.
Of the 4259 women included (mean age, 55.6 years), 1703 lived in major cities, 1629 inner regional, 794 outer regional, and 133 remote areas. Over the 15-year follow-up, 1401 (32.9%) women received treatment, including 47.4% of women with osteoporosis and 29.9% with fractures. Women in outer regional and remote areas were less likely to use antiosteoporosis treatment than those in major cities on univariable analysis (outer regional odds ratio, 0.83; 95% CI, 0.72-0.95; remote, 0.65; 0.49-0.86), but this did not remain significant on multivariable analysis. Median duration of use was 10 to 36 months, adherence varied by treatment type (34%-100%) but was not related to incident fractures, and of the women who stopped denosumab, 85% did not receive another consolidating treatment.
One-third of women with osteoporosis/fractures received treatment, and adherence was low. There was no difference in treatment use between urban and rural areas after adjusting for risk factors, although the specific treatment used, and adherence, differed.
骨质疏松症影响着超过半数的老年女性，但许多患者未接受治疗。目前尚不清楚城乡地区在治疗方面是否存在差异。
研究澳大利亚城乡绝经后女性在骨质疏松症治疗方面的差异。
纳入参加澳大利亚女性健康纵向研究的女性，这是一项前瞻性纵向队列研究，她们出生于1946年至1951年之间，患有骨质疏松症或骨折。将2004年至2019年的调查数据与药品福利计划（政府补贴药物）相关联，以评估骨质疏松症的治疗和依从性，并对不同地理区域进行比较。
纳入的4259名女性（平均年龄55.6岁）中，1703人居住在主要城市，1629人居住在内陆地区，794人居住在偏远地区，133人居住在偏远地区。在15年的随访中，1401名（32.9%）女性接受了治疗，其中47.4%的骨质疏松症女性和29.9%的骨折女性接受了治疗。单因素分析显示，偏远地区和偏远地区的女性使用抗骨质疏松治疗的可能性低于主要城市的女性（偏远地区比值比为0.83；95%CI为0.72-0.95；偏远地区为0.65；0.49-0.86），但在多因素分析中，这一差异不再显著。使用的中位持续时间为10至36个月，依从性因治疗类型而异（34%-100%），但与骨折发生率无关，在停止使用地诺单抗的女性中，85%未接受其他巩固治疗。
三分之一的骨质疏松症/骨折女性接受了治疗，且依从性较低。在调整风险因素后，城乡地区在治疗使用方面没有差异，尽管所使用的具体治疗方法和依从性有所不同。
