Regional differences in treatment for osteoporosis. The Global Longitudinal Study of Osteoporosis in Women (GLOW)

被引：77

作者：

Diez-Perez, Adolfo ^{[1
,2
]}

Hooven, Frederick H. ^{[3
]}

Adachi, Jonathan D. ^{[4
]}

Adami, Silvano ^{[5
]}

Anderson, Frederick A. ^{[3
]}

Boonen, Steven ^{[6
]}

Chapurlat, Roland ^{[7
]}

Compston, Juliet E. ^{[8
]}

Cooper, Cyrus ^{[9
,10
]}

Delmas, Pierre ^{[11
]}

Greenspan, Susan L. ^{[12
]}

LaCroix, Andrea Z. ^{[13
]}

Lindsay, Robert ^{[14
]}

Netelenbos, J. Coen ^{[15
]}

Pfeilschifter, Johannes ^{[16
]}

Roux, Christian ^{[17
]}

Saag, Kenneth G. ^{[18
]}

Sambrook, Philip ^{[19
]}

Silverman, Stuart ^{[20
]}

Siris, Ethel S. ^{[21
]}

Watts, Nelson B. ^{[22
]}

Nika, Grigor ^{[3
]}

Gehlbach, Stephen H. ^{[3
]}

机构：

[1] Autonomous Univ Barcelona, Hosp del Mar, IMIM, Barcelona 08003, Spain

[2] Inst Salud Carlos III, RETICEF, Barcelona, Spain

[3] Univ Massachusetts, Sch Med, Ctr Outcomes Res, Worcester, MA USA

[4] McMaster Univ, St Josephs Hosp, Hamilton, ON, Canada

[5] Univ Verona, Dept Rheumatol, I-37100 Verona, Valeggio, Italy

[6] Katholieke Univ Leuven, Div Geriatr Med, Leuven Univ Ctr Metab Bone Dis, Louvain, Belgium

[7] Univ Lyon, INSERM, Dept Orthoped & Rheumatol, Hop E Herriot,Res Unit 831, Lyon, France

[8] Univ Cambridge, Addenbrookes Hosp, Sch Clin Med, Cambridge CB2 2QQ, England

[9] Univ Southampton, MRC Epidemiol Resource Ctr, Southampton Gen Hosp, Oxford, England

[10] Univ Oxford, Norman Collisson Chair Musculoskeletal Sci, Oxford, England

[11] Hop Edouard Herriot, Lyon, France

[12] Univ Pittsburgh, Pittsburgh, PA USA

[13] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA

[14] Helen Hayes Hosp, Reg Bone Ctr, W Haverstraw, NY USA

[15] Vrije Univ Amsterdam, Med Ctr, Dept Endocrinol, Amsterdam, Netherlands

[16] Alfried Krupp Hosp, Dept Internal Med 3, Essen, Germany

[17] Paris Descartes Univ, Cochin Hosp, Paris, France

[18] Univ Alabama, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA

[19] Univ Sydney, Royal N Shore Hosp, Sydney, NSW 2006, Australia

[20] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA

[21] Columbia Univ, Med Ctr, New York, NY USA

[22] Univ Cincinnati, Bone Hlth & Osteoporosis Ctr, Cincinnati, OH USA

来源：

BONE | 2011年 / 49卷 / 03期

关键词：

Regional variation; Women; Risk factor; Preventive treatment; CLINICAL RISK-FACTORS; BONE-MINERAL DENSITY; POSTMENOPAUSAL WOMEN; FRACTURE RISK; ASSESSMENT-TOOL; ABSOLUTE RISK; PRIMARY-CARE; MEN; PREDICTION; POPULATION;

D O I：

10.1016/j.bone.2011.05.007

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Purpose: To determine if important geographic differences exist in treatment rates for osteoporosis and whether this variation can be explained by regional variation in risk factors. Methods: The Global Longitudinal Study of Osteoporosis in Women is an observational study of women >= 55 years sampled from primary care practices in 10 countries. Self-administered questionnaires were used to collect data on patient characteristics, risk factors for fracture, previous fractures, anti-osteoporosis medication, and health status. Results: Among 58,009 women, current anti-osteoporosis medication use was lowest in Northern Europe (16%) and highest in USA and Australia (32%). Between 48% (USA, Southern Europe) and 68% (Northern Europe) of women aged 65 years with a history of spine or hip fracture since age 45 were untreated. Among women with osteoporosis, the percentage of treated cases was lowest in Europe (45-52% versus 62-65% elsewhere). Women with osteopenia and no other risk factors were treated with anti-osteoporosis medication most frequently in USA (31%) and Canada (31%), and least frequently in Southern Europe (12%), Northern Europe (13%), and Australia (16%). After adjusting for risk factors, US women were threefold as likely to be treated with anti-osteoporosis medication as Northern European women (odds ratio 2.8: 95% confidence interval 2.5-3.1) and 1.5 times as likely to be treated as Southern European women (1.5, 1.4-1.6). Up to half of women reporting previous hip or spine fracture did not receive treatment. Conclusions: The likelihood of being treated for osteoporosis differed between regions, and cannot be explained by variation in risk factors. Many women at risk of fracture do not receive prophylaxis. (C) 2011 Elsevier Inc. All rights reserved.

引用

页码：493 / 498

页数：6

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