Prevention and treatment of osteoporosis in primary care offices

Objectives: To examine the use of medications for prevention and treatment of osteoporosis and testing for osteoporosis for postmenopausal women in primary care offices. Method: This cross-sectional survey study uses electronic medical records data over a 1-year period (January-December 2000) of women greater than or equal to55 years of age, either with (n = 31) or without (n = 782) a diagnosis of osteoporosis, who were active patients of two family practice and three gynecology offices in Delaware (n = 813). It presents documented use of medications for prevention or treatment of osteoporosis (estrogens, bisphosphonates, raloxifene, calcitonin, or calcium) and receipt of bone mineral density (BMD) testing. Results: Of women without osteoporosis, 27.4% were taking prescription osteoporosis-related medications, and 32.9% were taking prescription medications or calcium supplements or both. Women were less likely to be taking these medications if they were >70 years of age (adjusted odds ratio [OR] = 0.42, p < 0.01) or were patients of gynecologists (adjusted OR = 0.48, p < 0.01). They were not more likely to take medications if they had risk factors for osteoporosis. Of women with osteoporosis, 58.1% were taking prescription osteoporosis-related medications, and 61.3% were taking prescription medications or calcium or both. BMD testing was done for 34% of all women and was not more likely for those with risk factors. Conclusions: In family medicine and gynecology offices, most postmenopausal women do not take preventive medications or get testing for osteoporosis. Even among those with known osteoporosis, many do not take medications for treatment of their osteoporosis.