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Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong?
J Bone Miner Res 2005; 20(6):898-905JB

Abstract

A worldwide epidemic of hip fractures has been predicted. Time trends in BMD testing, bone-sparing medications and hip and wrist fractures in the province of Ontario, Canada, were examined. From 1996 to 2001, BMD testing and use of bone-sparing medications increased each year, whereas despite the aging of the population, wrist and hip fracture rates decreased.

INTRODUCTION

If patients with osteoporosis are being diagnosed and effective treatments used with increasing frequency in the population, rates of hip and wrist fractures will remain stable or possibly decrease. We report here time trends in BMD testing, prescriptions for bone-sparing medications, hip and wrist fracture rates, and population projections of fracture rates to 2005 in the province of Ontario, Canada.

MATERIALS AND METHODS

Ontario residents have universal access to Medicare. To examine time trends in BMD testing, all physician claims for DXA from 1992 to 2001 were selected from the Ontario Health Insurance Plan (OHIP) database. Trends in prescribing were examined from 1996 to 2003 using data from the Ontario Drug Benefit plan, which provides coverage to persons > or = 65 years of age. Actual numbers of hip and wrist fractures were determined for 1992-2000 and population projections for 2001-2005 using time-series analysis. Wrist fractures were identified in the OHIP database and hip fractures through hospital discharge abstracts.

RESULTS

From 1992 to 2001, the number of BMD tests increased 10-fold. There has been a steady increase in the number of persons filling prescriptions for antiresorptives (12,298 in 1996 to 225,580 in 2003) and the majority were for etidronate. For women, the rate of decline for wrist fractures is greater than that for hip fractures. The rate of hip fracture was fairly constant around 41 per 10,000 women > or = 50 years between 1992 and 1996. In 1997, the hip fracture rate began to decrease, and the population projections suggest that this downward trend will continue to a rate of 33.1 per 10,000 in 2005.

CONCLUSIONS

Our findings suggest that fracture rates may be on the decline, despite the aging of the population, because of increased patterns of diagnosis and treatment for osteoporosis.

Authors+Show Affiliations

Department of Rehabilitation Science, University of Toronto, Toronto, Canada. susan.jaglal@utoronto.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo 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

15883628

Citation

Jaglal, Susan B., et al. "Population Trends in BMD Testing, Treatment, and Hip and Wrist Fracture Rates: Are the Hip Fracture Projections Wrong?" Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 6, 2005, pp. 898-905.
Jaglal SB, Weller I, Mamdani M, et al. Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? J Bone Miner Res. 2005;20(6):898-905.
Jaglal, S. B., Weller, I., Mamdani, M., Hawker, G., Kreder, H., Jaakkimainen, L., & Adachi, J. D. (2005). Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(6), pp. 898-905.
Jaglal SB, et al. Population Trends in BMD Testing, Treatment, and Hip and Wrist Fracture Rates: Are the Hip Fracture Projections Wrong. J Bone Miner Res. 2005;20(6):898-905. PubMed PMID: 15883628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Population trends in BMD testing, treatment, and hip and wrist fracture rates: are the hip fracture projections wrong? AU - Jaglal,Susan B, AU - Weller,Iris, AU - Mamdani,Muhammad, AU - Hawker,Gillian, AU - Kreder,Hans, AU - Jaakkimainen,Liisa, AU - Adachi,Jonathan D, Y1 - 2004/12/20/ PY - 2004/03/16/received PY - 2004/12/06/revised PY - 2004/12/17/accepted PY - 2005/5/11/pubmed PY - 2005/10/4/medline PY - 2005/5/11/entrez SP - 898 EP - 905 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 - 20 IS - 6 N2 - UNLABELLED: A worldwide epidemic of hip fractures has been predicted. Time trends in BMD testing, bone-sparing medications and hip and wrist fractures in the province of Ontario, Canada, were examined. From 1996 to 2001, BMD testing and use of bone-sparing medications increased each year, whereas despite the aging of the population, wrist and hip fracture rates decreased. INTRODUCTION: If patients with osteoporosis are being diagnosed and effective treatments used with increasing frequency in the population, rates of hip and wrist fractures will remain stable or possibly decrease. We report here time trends in BMD testing, prescriptions for bone-sparing medications, hip and wrist fracture rates, and population projections of fracture rates to 2005 in the province of Ontario, Canada. MATERIALS AND METHODS: Ontario residents have universal access to Medicare. To examine time trends in BMD testing, all physician claims for DXA from 1992 to 2001 were selected from the Ontario Health Insurance Plan (OHIP) database. Trends in prescribing were examined from 1996 to 2003 using data from the Ontario Drug Benefit plan, which provides coverage to persons > or = 65 years of age. Actual numbers of hip and wrist fractures were determined for 1992-2000 and population projections for 2001-2005 using time-series analysis. Wrist fractures were identified in the OHIP database and hip fractures through hospital discharge abstracts. RESULTS: From 1992 to 2001, the number of BMD tests increased 10-fold. There has been a steady increase in the number of persons filling prescriptions for antiresorptives (12,298 in 1996 to 225,580 in 2003) and the majority were for etidronate. For women, the rate of decline for wrist fractures is greater than that for hip fractures. The rate of hip fracture was fairly constant around 41 per 10,000 women > or = 50 years between 1992 and 1996. In 1997, the hip fracture rate began to decrease, and the population projections suggest that this downward trend will continue to a rate of 33.1 per 10,000 in 2005. CONCLUSIONS: Our findings suggest that fracture rates may be on the decline, despite the aging of the population, because of increased patterns of diagnosis and treatment for osteoporosis. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15883628/Population_trends_in_BMD_testing_treatment_and_hip_and_wrist_fracture_rates:_are_the_hip_fracture_projections_wrong L2 - https://doi.org/10.1359/JBMR.041231 DB - PRIME DP - Unbound Medicine ER -