Patterns of anti-osteoporosis medication use among women at high risk of fracture: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)

PLoS One. 2013 Dec 20;8(12):e82840. doi: 10.1371/journal.pone.0082840. eCollection 2013.

Abstract

Objective: To assess patterns of anti-osteoporosis medication (AOM) use over 3 years among women at high risk of major fracture.

Methods: The GLOW registry follows a cohort of more than 40,000 women aged ≥ 55 from 615 primary care practices in 10 countries. Self-administered surveys (baseline, 12, 24, and 36 months) collected data on patient characteristics, perception of fracture risk, and AOM use. FRAX scores were calculated from the baseline surveys and women classified as high risk if their FRAX 10-year probability of major fracture was ≥ 20%.

Results: A total of 5774 women were classified as at high risk and had complete data over 3 years. At baseline, 2271 (39%) reported receiving AOM, 739 (13%) reported prior but not current use, and 2764 (48%) said they had never used AOM. Over 3 years, 85% of baseline non-users continued as non-users and 15% initiated AOM; among baseline users, 49% continued the same medication class, 29% stopped AOM, and 12% switched. Women who stopped AOM were less likely to self-report osteoporosis (HR 0.56, 95% CI 0.42-0.75) than women who continued AOM. Compared with non-users who did not begin treatment, women initiating AOM were more likely to report a diagnosis of osteoporosis (HR 11.3, 95% CI 8.2-15.5) or osteopenia (HR 4.1, 95% CI 2.9-5.7) and be very concerned about osteoporosis (HR 1.9, 95% CI 1.3-2.8).

Conclusions: Less than 40% of women at high risk of fracture reported taking AOM. Women who stopped AOM were less likely to believe they have osteoporosis. Women who initiated treatment appeared motivated primarily by a diagnosis of osteoporosis or osteopenia and concern about the condition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bone Density Conservation Agents / therapeutic use*
  • Female
  • Fractures, Bone / drug therapy*
  • Fractures, Bone / epidemiology*
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Multivariate Analysis
  • Osteoporosis / drug therapy*
  • Osteoporosis / epidemiology*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Risk Factors

Substances

  • Bone Density Conservation Agents

Grants and funding

Financial support for the GLOW study is provided to the Center for Outcomes Research, University of Massachusetts Medical School by Warner Chilcott Company, LLC, and sanofi-aventis. This analysis was sponsored by Pfizer Inc. Stephen Gehlbach, Frederick Hooven, Allison Wyman, and Frederick Anderson are employees of University of Massachusetts Medical School, which received financial support from Pfizer in connection with the development of this manuscript. The funders (Warner Chilcott Company, LLC, and sanofi-aventis) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Pfizer had a role in the study as employer of authors Xuemei Luo and Andrew Bushmakin, who reviewed the data and wrote/contributed to the final manuscript. The authors had full access to all the data and the corresponding author had final responsibility for the decision to submit for publication. Editorial services provided by Sophie Rushton-Smith, PhD (COR, UMass Medical School, Worcester, USA) were funded by Pfizer.