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Osteoporosis prevalence and levels of treatment in primary care: the Australian BoneCare Study.
J Bone Miner Res. 2004 Dec; 19(12):1969-75.JB

Abstract

The level of recognition and treatment of osteoporosis is not well characterized in primary care. In data from a large sample of postmenopausal women attending 927 primary care physicians, 29% of women reported one or more fractures after menopause. The great majority (72%) were not on any osteoporosis-specific therapy.

INTRODUCTION

Osteoporosis is often first recognized at the time of a low-trauma fracture. However, by this stage, the risk of subsequent fractures has already risen substantially. Moreover, in many countries, only a small proportion of women, who have already sustained fractures, receive a treatment shown to reduce this increased risk of further fractures.

MATERIALS AND METHODS

This project was initiated to examine the prevalence of osteoporotic fractures, risk factors for osteoporosis, and use of antifracture therapy among postmenopausal Australian women. More than 88,000 women from 927 primary care physicians returned over 69,358 surveys. Of these, 57,088 reported the presence of a postmenopausal fracture or risk factors.

RESULTS

Among these randomly selected postmenopausal women, 29% reported having had one or more low-trauma fractures after menopause (44% substantiated in current records). One-third of these women reported multiple fractures. The prevalence of all types of fractures, except rib and ankle, increased with age and low body weight. Those who reported fractures were also more likely to report early menopause, corticosteroid use, and a family history of osteoporosis. Moreover, those with vertebral fractures were more likely to record height loss, kyphosis, and back pain. Physical inactivity, low calcium intake, and smoking had no consistent relationship with any fracture outcome. Of the women who reported a fracture after menopause, only 28% were on any specific therapy for osteoporosis, and 7% were on calcium alone. Of those who had been told they had osteoporosis by a doctor, 40% were receiving specific osteoporosis therapy.

CONCLUSIONS

In this large study of postmenopausal Australian women attending primary care physicians, 29% reported at least one low-trauma fracture after menopause. Less than one-third of these women were on specific treatment for osteoporosis, and only 40% were ever told they had osteoporosis. Therefore, osteoporotic fractures are common in postmenopausal Australian women, and few, despite their substantially increased risk of further fractures, are on any specific anti-osteoporotic therapy. These data support the need for more effective education for the community and medical practitioners of the clinical significance of osteoporotic fractures and alternatives for treatment.

Authors+Show Affiliations

Garvan Institute of Medical Research, University of New South Wales, St. Vincent's Hospital, 384 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia. j.eisman@garvan.org.auNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15537439

Citation

Eisman, John, et al. "Osteoporosis Prevalence and Levels of Treatment in Primary Care: the Australian BoneCare Study." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 19, no. 12, 2004, pp. 1969-75.
Eisman J, Clapham S, Kehoe L, et al. Osteoporosis prevalence and levels of treatment in primary care: the Australian BoneCare Study. J Bone Miner Res. 2004;19(12):1969-75.
Eisman, J., Clapham, S., & Kehoe, L. (2004). Osteoporosis prevalence and levels of treatment in primary care: the Australian BoneCare Study. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 19(12), 1969-75.
Eisman J, et al. Osteoporosis Prevalence and Levels of Treatment in Primary Care: the Australian BoneCare Study. J Bone Miner Res. 2004;19(12):1969-75. PubMed PMID: 15537439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Osteoporosis prevalence and levels of treatment in primary care: the Australian BoneCare Study. AU - Eisman,John, AU - Clapham,Sharon, AU - Kehoe,Linda, AU - ,, Y1 - 2004/09/13/ PY - 2004/02/16/received PY - 2004/07/01/revised PY - 2004/07/23/accepted PY - 2004/11/13/pubmed PY - 2005/5/6/medline PY - 2004/11/13/entrez SP - 1969 EP - 75 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 19 IS - 12 N2 - UNLABELLED: The level of recognition and treatment of osteoporosis is not well characterized in primary care. In data from a large sample of postmenopausal women attending 927 primary care physicians, 29% of women reported one or more fractures after menopause. The great majority (72%) were not on any osteoporosis-specific therapy. INTRODUCTION: Osteoporosis is often first recognized at the time of a low-trauma fracture. However, by this stage, the risk of subsequent fractures has already risen substantially. Moreover, in many countries, only a small proportion of women, who have already sustained fractures, receive a treatment shown to reduce this increased risk of further fractures. MATERIALS AND METHODS: This project was initiated to examine the prevalence of osteoporotic fractures, risk factors for osteoporosis, and use of antifracture therapy among postmenopausal Australian women. More than 88,000 women from 927 primary care physicians returned over 69,358 surveys. Of these, 57,088 reported the presence of a postmenopausal fracture or risk factors. RESULTS: Among these randomly selected postmenopausal women, 29% reported having had one or more low-trauma fractures after menopause (44% substantiated in current records). One-third of these women reported multiple fractures. The prevalence of all types of fractures, except rib and ankle, increased with age and low body weight. Those who reported fractures were also more likely to report early menopause, corticosteroid use, and a family history of osteoporosis. Moreover, those with vertebral fractures were more likely to record height loss, kyphosis, and back pain. Physical inactivity, low calcium intake, and smoking had no consistent relationship with any fracture outcome. Of the women who reported a fracture after menopause, only 28% were on any specific therapy for osteoporosis, and 7% were on calcium alone. Of those who had been told they had osteoporosis by a doctor, 40% were receiving specific osteoporosis therapy. CONCLUSIONS: In this large study of postmenopausal Australian women attending primary care physicians, 29% reported at least one low-trauma fracture after menopause. Less than one-third of these women were on specific treatment for osteoporosis, and only 40% were ever told they had osteoporosis. Therefore, osteoporotic fractures are common in postmenopausal Australian women, and few, despite their substantially increased risk of further fractures, are on any specific anti-osteoporotic therapy. These data support the need for more effective education for the community and medical practitioners of the clinical significance of osteoporotic fractures and alternatives for treatment. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15537439/Osteoporosis_prevalence_and_levels_of_treatment_in_primary_care:_the_Australian_BoneCare_Study_ L2 - https://doi.org/10.1359/JBMR.040905 DB - PRIME DP - Unbound Medicine ER -