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25-Hydroxyvitamin D in Canadian adults: biological, environmental, and behavioral correlates.

https://arctichealth.org/en/permalink/ahliterature141385
Source
Osteoporos Int. 2011 May;22(5):1389-99
Publication Type
Article
Date
May-2011
Author
L S Greene-Finestone
C. Berger
M. de Groh
D A Hanley
N. Hidiroglou
K. Sarafin
S. Poliquin
J. Krieger
J B Richards
D. Goltzman
Author Affiliation
Public Health Agency of Canada, Ottawa, Ontario, Canada. linda.greene-finestone@phac-aspc.gc.ca
Source
Osteoporos Int. 2011 May;22(5):1389-99
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Body mass index
Canada - epidemiology
Cross-Sectional Studies
Diet - statistics & numerical data
Dietary Supplements
Female
Humans
Male
Middle Aged
Obesity - complications - epidemiology
Seasons
Sex Distribution
Skin Pigmentation - physiology
Sunlight
Vitamin D - administration & dosage - analogs & derivatives - blood
Vitamin D Deficiency - blood - epidemiology - etiology
Abstract
We assessed vitamin D status and its correlates in the population-based Canadian Multicentre Osteoporosis Study (CaMos). Results showed that serum 25-hydroxyvitamin D levels
PubMed ID
20730415 View in PubMed
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Associations among disease conditions, bone mineral density, and prevalent vertebral deformities in men and women 50 years of age and older: cross-sectional results from the Canadian Multicentre Osteoporosis Study.

https://arctichealth.org/en/permalink/ahliterature186024
Source
J Bone Miner Res. 2003 Apr;18(4):784-90
Publication Type
Article
Date
Apr-2003
Author
D A Hanley
J P Brown
A. Tenenhouse
W P Olszynski
G. Ioannidis
C. Berger
J C Prior
L. Pickard
T M Murray
T. Anastassiades
S. Kirkland
C. Joyce
L. Joseph
A. Papaioannou
S A Jackson
S. Poliquin
J D Adachi
Author Affiliation
Department of Medicine, University of Calgary. Calgary, Alberta, Canada. dahanley@ucalgary.ca
Source
J Bone Miner Res. 2003 Apr;18(4):784-90
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bone Density
Canada - epidemiology
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 2 - complications
Female
Humans
Hypertension - complications
Kidney Calculi - complications
Male
Middle Aged
Osteitis Deformans - complications
Osteoporosis - complications - epidemiology
Spine - abnormalities
Abstract
This cross-sectional cohort study of 5566 women and 2187 men 50 years of age and older in the population-based Canadian Multicentre Osteoporosis Study was conducted to determine whether reported past diseases are associated with bone mineral density or prevalent vertebral deformities. We examined 12 self-reported disease conditions including diabetes mellitus (types 1 or 2), nephrolithiasis, hypertension, heart attack, rheumatoid arthritis, thyroid disease, breast cancer, inflammatory bowel disease, neuromuscular disease, Paget's disease, and chronic obstructive pulmonary disease. Multivariate linear and logistic regression analyses were performed to determine whether there were associations among these disease conditions and bone mineral density of the lumbar spine, femoral neck, and trochanter, as well as prevalent vertebral deformities. Bone mineral density measurements were higher in women and men with type 2 diabetes compared with those without after appropriate adjustments. The differences were most notable at the lumbar spine (+0.053 g/cm2), femoral neck (+0.028 g/cm2), and trochanter (+0.025 g/cm2) in women, and at the femoral neck (+0.025 g/cm2) in men. Hypertension was also associated with higher bone mineral density measurements for both women and men. The differences were most pronounced at the lumbar spine (+0.022 g/cm2) and femoral neck (+0.007 g/cm2) in women and at the lumbar spine (+0.028 g/cm2) in men. Although results were statistically inconclusive, men reporting versus not reporting past nephrolithiasis appeared to have clinically relevant lower bone mineral density values. Bone mineral density differences were -0.022, -0.015, and -0.016 g/cm2 at the lumbar spine, femoral neck, and trochanter, respectively. Disease conditions were not strongly associated with vertebral deformities. In summary, these cross-sectional population-based data show that type 2 diabetes and hypertension are associated with higher bone mineral density in women and men, and nephrolithiasis may be associated with lower bone mineral density in men. The importance of these associations for osteoporosis case finding and management require further and prospective studies.
PubMed ID
12674340 View in PubMed
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Bone mineral density during puberty in western Canadian children.

https://arctichealth.org/en/permalink/ahliterature223000
Source
Bone Miner. 1992 Oct;19(1):85-96
Publication Type
Article
Date
Oct-1992
Author
S K Grimston
K. Morrison
J A Harder
D A Hanley
Author Affiliation
Human Performance Laboratory, Faculty of Physical Education, University of Calgary, Alta., Canada.
Source
Bone Miner. 1992 Oct;19(1):85-96
Date
Oct-1992
Language
English
Publication Type
Article
Keywords
Adolescent
Anthropometry
Bone Development
Calcification, Physiologic
Calcium - metabolism
Canada
Child
Energy Metabolism
Female
Humans
Male
Neck - anatomy & histology
Puberty
Regression Analysis
Sex Factors
Swimming
Abstract
To assess the influence of puberty and its associated changes in body weight and height on bone mineral density (BMD), lumbar spine (L2-L4) and femoral neck BMD were measured in 74 healthy, active children (9-16 years) using dual-photon absorptiometry. Competitive swimmers were recruited to minimize the potential effect variability in mechanical loading regime may have on bone density of the lumbar spine. Tanner staging was used to assess stage of puberty. Current dietary calcium intake was assessed by analysis of 6-day dietary records. Significant differences in spinal and femoral neck BMD occurred between early (Tanner 1 and 2) and late stages of puberty (Tanner 4 and 5), P
PubMed ID
1422308 View in PubMed
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Canadian normative data for the SF-36 health survey. Canadian Multicentre Osteoporosis Study Research Group.

https://arctichealth.org/en/permalink/ahliterature197488
Source
CMAJ. 2000 Aug 8;163(3):265-71
Publication Type
Article
Date
Aug-8-2000
Author
W M Hopman
T. Towheed
T. Anastassiades
A. Tenenhouse
S. Poliquin
C. Berger
L. Joseph
J P Brown
T M Murray
J D Adachi
D A Hanley
E. Papadimitropoulos
Author Affiliation
MacKenzie Health Services Research Group, Queen's University, Kingston, Ont. hopmanw@post.queensu.ca
Source
CMAJ. 2000 Aug 8;163(3):265-71
Date
Aug-8-2000
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Age Distribution
Aged
Canada - epidemiology
Female
Great Britain - epidemiology
Health status
Health Status Indicators
Health Surveys
Humans
Male
Mental health
Middle Aged
Outcome Assessment (Health Care)
Prospective Studies
Quality of Life
Questionnaires
Reference Values
Sex Distribution
Socioeconomic Factors
United States - epidemiology
Urban health
Abstract
The Medical Outcomes Study 36-item Short Form (SF-36) is a widely used measure of health-related quality of life. Normative data are the key to determining whether a group or an individual scores above or below the average for their country, age or sex. Published norms for the SF-36 exist for other countries but have not been previously published for Canada.
The Canadian Multicentre Osteoporosis Study is a prospective cohort study involving 9423 randomly selected Canadian men and women aged 25 years or more living in the community. The sample was drawn within a 50-km radius of 9 Canadian cities, and the information collected included the SF-36 as a measure of health-related quality of life. This provided a unique opportunity to develop age- and sex-adjusted normative data for the Canadian population.
Canadian men scored substantially higher than women on all 8 domains and the 2 summary component scales of the SF-36. Canadians scored higher than their US counterparts on all SF-36 domains and both summary component scales and scored higher than their UK counterparts on 4 domains, although many of the differences are not large.
The differences in the SF-36 scores between age groups, sexes and countries confirm that these Canadian norms are necessary for comparative purposes. The data will be useful for assessing the health status of the general population and of patient populations, and the effect of interventions on health-related quality of life.
Notes
Cites: Med Care. 1992 Jun;30(6):473-831593914
Cites: J Epidemiol Community Health. 1999 Jan;53(1):46-5010326053
Cites: Med Care. 1993 Mar;31(3):247-638450681
Cites: BMJ. 1993 May 29;306(6890):1437-408518639
Cites: Med Care. 1994 Jan;32(1):40-668277801
Cites: Med Care. 1995 Apr;33(4 Suppl):AS264-797723455
Cites: J Public Health Med. 1995 Mar;17(1):46-507786567
Cites: Int J Technol Assess Health Care. 1995 Summer;11(3):525-517591551
Cites: Aust N Z J Public Health. 1996 Aug;20(4):359-638908757
Cites: J Clin Epidemiol. 1997 Jan;50(1):79-939048693
Cites: Med Care. 1997 May;35(5):522-379140339
Cites: Clin Invest Med. 1997 Aug;20(4):224-389258577
Cites: BMJ. 1997 Nov 15;315(7118):1273-99390054
Cites: Qual Life Res. 1998 Apr;7(3):215-209584551
Comment In: CMAJ. 2000 Aug 8;163(3):283-410951725
PubMed ID
10951722 View in PubMed
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Construction of a FRAX® model for the assessment of fracture probability in Canada and implications for treatment.

https://arctichealth.org/en/permalink/ahliterature138602
Source
Osteoporos Int. 2011 Mar;22(3):817-27
Publication Type
Article
Date
Mar-2011
Author
W D Leslie
L M Lix
L. Langsetmo
C. Berger
D. Goltzman
D A Hanley
J D Adachi
H. Johansson
A. Oden
E. McCloskey
J A Kanis
Author Affiliation
University of Manitoba, Winnipeg, Canada. bleslie@sbgh.mb.ca
Source
Osteoporos Int. 2011 Mar;22(3):817-27
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Aged
Aged, 80 and over
Bone Density
Canada - epidemiology
Female
Femur Neck - radiography
Hip Fractures - epidemiology - rehabilitation
Humans
Male
Middle Aged
Multicenter Studies as Topic
Osteoporotic Fractures - epidemiology - rehabilitation
Risk Assessment - methods
Risk factors
Spinal Fractures - epidemiology
World Health Organization
Abstract
We describe the creation of a FRAX® model for the assessment of fracture probability in Canadian men and women, calibrated from national hip fracture and mortality data. This FRAX tool was used to examine possible thresholds for therapeutic intervention in Canada in two large complementary cohorts of women and men.
To evaluate a Canadian World Health Organization (WHO) fracture risk assessment (FRAX®) tool for computing 10-year probabilities of osteoporotic fracture.
Fracture probabilities were computed from national hip fracture data (2005) and death hazards (2004) for Canada. Probabilities took account of age, sex, clinical risk factors (CRFs), and femoral neck bone mineral density (BMD). Treatment implications were studied in two large cohorts of individuals age 50 years and older: the population-based Canadian Multicentre Osteoporosis Study (4,778 women and 1,919 men) and the clinically referred Manitoba BMD Cohort (36,730 women and 2,873 men).
Fracture probabilities increased with age, decreasing femoral neck T-score, and number of CRFs. Among women, 10.1-11.3% would be designated high risk based upon 10-year major osteoporotic fracture probability exceeding 20%. A much larger proportion would be designated high risk based upon 10-year hip fracture probability exceeding 3% (25.7-28.0%) or osteoporotic BMD (27.1-30.9%), and relatively few from prior hip or clinical spine fracture (1.6-4.2%). One or more criteria for intervention were met by 29.2-34.0% of women excluding hip fracture probability (35.3-41.0% including hip fracture probability). Lower intervention rates were seen among CaMos (Canadian Multicentre Osteoporosis Study) men (6.8-12.9%), but in clinically referred men from the Manitoba BMD Cohort, one or more criteria for high risk were seen for 26.4% excluding hip fracture probability (42.4% including hip fracture probability).
The FRAX tool can be used to identify intervention thresholds in Canada. The FRAX model supports a shift from a dual X-ray absorptiometry (DXA)-based intervention strategy, towards a strategy based on fracture probability for a major osteoporotic fracture.
PubMed ID
21161509 View in PubMed
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Cost-effectiveness of a multifaceted intervention to improve quality of osteoporosis care after wrist fracture.

https://arctichealth.org/en/permalink/ahliterature140406
Source
Osteoporos Int. 2011 Jun;22(6):1799-808
Publication Type
Article
Date
Jun-2011
Author
S R Majumdar
D A Lier
B H Rowe
A S Russell
F A McAlister
W P Maksymowych
D A Hanley
D W Morrish
J A Johnson
Author Affiliation
Department of Medicine, University of Alberta, Edmonton, AB, Canada. me2.majumdar@ualberta.ca
Source
Osteoporos Int. 2011 Jun;22(6):1799-808
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Aged
Alberta
Bone Density - physiology
Cost-Benefit Analysis
Decision Support Techniques
Epidemiologic Methods
Female
Health Care Costs - statistics & numerical data
Humans
Male
Middle Aged
Models, Econometric
Osteoporosis - complications - economics - physiopathology - therapy
Osteoporotic Fractures - economics - physiopathology - prevention & control
Quality Improvement - economics - organization & administration
Quality-Adjusted Life Years
Recurrence - prevention & control
Wrist Injuries - etiology - physiopathology
Abstract
In a randomized trial, a multifaceted intervention tripled rates of osteoporosis treatment in older patients with wrist fracture. An economic analysis of the trial now demonstrates that the intervention tested "dominates" usual care: over a lifetime horizon, it reduces fracture, increases quality-adjusted life years, and saves the healthcare system money.
In a randomized trial (N = 272), we reported a multifaceted quality improvement intervention directed at older patients and their physicians could triple rates of osteoporosis treatment within 6 months of a wrist fracture when compared with usual care (22% vs 7%). Alongside the trial, we conducted an economic evaluation.
Using 1-year outcome data from our trial and micro-costing time-motion studies, we constructed a Markov decision-analytic model to determine cost-effectiveness of the intervention compared with usual care over the patients' remaining lifetime. We took the perspective of third-party healthcare payers. In the base case, costs and benefits were discounted at 3% and expressed in 2006 Canadian dollars. One-way deterministic and probabilistic sensitivity analyses were conducted.
Median age of patients was 60 years, 77% were women, and 72% had low bone mineral density (BMD). The intervention cost $12 per patient. Compared with usual care, the intervention strategy was dominant: for every 100 patients receiving the intervention, three fractures (one hip fracture) would be prevented, 1.1 quality-adjusted life year gained, and $26,800 saved by the healthcare system over their remaining lifetime. The intervention dominated usual care across numerous one-way sensitivity analyses: with respect to cost, the most influential parameter was drug price; in terms of effectiveness, the most influential parameter was rate of BMD testing. The intervention was cost saving in 80% of probabilistic model simulations.
For outpatients with wrist fractures, our multifaceted osteoporosis intervention was cost-effective. Healthcare systems implementing similar interventions should expect to save money, reduce fractures, and gain quality-adjusted life expectancy.
PubMed ID
20878389 View in PubMed
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Could a policy of provision of hip protectors to elderly nursing home residents result in cost savings in acute hip fracture care? The case of Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature165651
Source
Osteoporos Int. 2007 Jun;18(6):819-27
Publication Type
Article
Date
Jun-2007
Author
A M Sawka
A. Gafni
P. Boulos
K. Beattie
A. Papaioannou
A. Cranney
D A Hanley
J D Adachi
A. Cheung
E A Papadimitropoulos
L. Thabane
Author Affiliation
Division of Endocrinology and Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada.
Source
Osteoporos Int. 2007 Jun;18(6):819-27
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Aged
Cost Savings - statistics & numerical data
Cost-Benefit Analysis
Health Care Costs - statistics & numerical data
Hip Fractures - economics - epidemiology - prevention & control
Homes for the Aged
Humans
Nursing Homes
Ontario - epidemiology
Protective Devices - economics
Randomized Controlled Trials as Topic
Abstract
Hip fractures are an important problem in nursing homes. Hip protectors are external devices that decrease the risk of hip fracture in elderly nursing home residents. We estimated the overall healthcare cost savings from a hypothetical strategy of provision of hip protectors to elderly nursing home residents in Ontario, Canada. In a recent meta-analysis, we determined that a strategy of provision of hip protectors decreases the risk of hip fracture in nursing home residents.
Our objective was to determine whether the provision of hip protectors to all Ontario nursing home residents aged > or =65 years could result in cost savings, stemming from reductions in initial hospitalizations for hip fracture.
We conducted a cost analysis from a Ministry of Health perspective (one year cycle length). The efficacy of the intervention was estimated from a meta-analysis of randomized controlled trials.
A strategy of provision of hip protectors to all 60,775 elderly Ontario nursing home residents could result in an overall mean cost savings of 6.0 million Canadian dollars in one year (95% credibility interval, -26.4 million, 39.7 million), with a probability of cost savings of 0.63 (assuming no additional labor costs). In sensitivity analyses, decreasing hip protector price increased cost savings, whereas additional labor expenditures for application for hip protectors decreased cost savings.
In conclusion, if hip protectors can be provided to elderly Ontario nursing home residents without additional labor expenditures, there is a reasonable probability that such a strategy may result in healthcare cost savings.
PubMed ID
17221294 View in PubMed
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Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos).

https://arctichealth.org/en/permalink/ahliterature195810
Source
Osteoporos Int. 2000;11(10):897-904
Publication Type
Article
Date
2000
Author
A. Tenenhouse
L. Joseph
N. Kreiger
S. Poliquin
T M Murray
L. Blondeau
C. Berger
D A Hanley
J C Prior
Author Affiliation
McGill University, Montreal General Hospital, Montreal, Canada.
Source
Osteoporos Int. 2000;11(10):897-904
Date
2000
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Adult
Aged
Aged, 80 and over
Aging - physiology
Bone Density
Canada - epidemiology
Female
Femur Neck - physiology - physiopathology
Humans
Lumbar Vertebrae - physiology - physiopathology
Male
Middle Aged
Osteoporosis - epidemiology - physiopathology
Osteoporosis, Postmenopausal - epidemiology - physiopathology
Prevalence
Prospective Studies
Reference Values
Abstract
The Canadian Multicentre Osteoporosis Study (CaMos) is a prospective cohort study which will measure the incidence and prevalence of osteoporosis and fractures, and the effect of putative risk factors, in a random sample of 10,061 women and men aged > or = 25 years recruited in approximately equal numbers in nine centers across Canada. In this paper we report the results of studies to establish peak bone mass (PBM) which would be appropriate reference data for use in Canada. These reference data are used to estimate the prevalence of osteoporosis and osteopenia in Canadian women and men aged > or = 50 years. Participants were recruited via randomly selected household telephone listings. Bone mineral density (BMD) of the lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry using Hologic QDR 1000 or 2000 or Lunar DPX densitometers. BMD results for lumbar spine and femoral neck were converted to a Hologic base. BMD of the lumbar spine in 578 women and 467 men was constant to age 39 years giving a PBM of 1.042 +/- 0.121 g/cm2 for women and 1.058 +/- 0.127 g/cm2 for men. BMD at the femoral neck declined from age 29 years. The mean femoral neck BMD between 25 and 29 years was taken as PBM and was found to be 0.857 +/- 0.125 g/cm2 for women and 0.910 +/- 0.125 g/cm2 for men. Prevalence of osteoporosis, as defined by WHO criteria, in Canadian women aged > or = 50 years was 12.1% at the lumbar spine and 7.9% at the femoral neck with a combined prevalence of 15.8%. In men it was 2.9% at the lumbar spine and 4.8% at the femoral neck with a combined prevalence of 6.6%.
PubMed ID
11199195 View in PubMed
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Fracture prediction and calibration of a Canadian FRAX® tool: a population-based report from CaMos.

https://arctichealth.org/en/permalink/ahliterature138603
Source
Osteoporos Int. 2011 Mar;22(3):829-37
Publication Type
Article
Date
Mar-2011
Author
L-A Fraser
L. Langsetmo
C. Berger
G. Ioannidis
D. Goltzman
J D Adachi
A. Papaioannou
R. Josse
C S Kovacs
W P Olszynski
T. Towheed
D A Hanley
S M Kaiser
J. Prior
S. Jamal
N. Kreiger
J P Brown
H. Johansson
A. Oden
E. McCloskey
J A Kanis
W D Leslie
Author Affiliation
Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada.
Source
Osteoporos Int. 2011 Mar;22(3):829-37
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Aged
Bone Density
Calibration
Canada - epidemiology
Female
Femur Neck - radiography
Hip Fractures - epidemiology
Humans
Male
Middle Aged
Multicenter Studies as Topic
Osteoporotic Fractures - epidemiology
Predictive value of tests
Prospective Studies
Reproducibility of Results
Risk Assessment - methods
Risk factors
World Health Organization
Abstract
A new Canadian WHO fracture risk assessment (FRAX®) tool to predict 10-year fracture probability was compared with observed 10-year fracture outcomes in a large Canadian population-based study (CaMos). The Canadian FRAX tool showed good calibration and discrimination for both hip and major osteoporotic fractures.
The purpose of this study was to validate a new Canadian WHO fracture risk assessment (FRAX®) tool in a prospective, population-based cohort, the Canadian Multicentre Osteoporosis Study (CaMos).
A FRAX tool calibrated to the Canadian population was developed by the WHO Collaborating Centre for Metabolic Bone Diseases using national hip fracture and mortality data. Ten-year FRAX probabilities with and without bone mineral density (BMD) were derived for CaMos women (N?=?4,778) and men (N?=?1,919) and compared with observed fracture outcomes to 10 years (Kaplan-Meier method). Cox proportional hazard models were used to investigate the contribution of individual FRAX variables.
Mean overall 10-year FRAX probability with BMD for major osteoporotic fractures was not significantly different from the observed value in men [predicted 5.4% vs. observed 6.4% (95%CI 5.2-7.5%)] and only slightly lower in women [predicted 10.8% vs. observed 12.0% (95%CI 11.0-12.9%)]. FRAX was well calibrated for hip fracture assessment in women [predicted 2.7% vs. observed 2.7% (95%CI 2.2-3.2%)] but underestimated risk in men [predicted 1.3% vs. observed 2.4% (95%CI 1.7-3.1%)]. FRAX with BMD showed better fracture discrimination than FRAX without BMD or BMD alone. Age, body mass index, prior fragility fracture and femoral neck BMD were significant independent predictors of major osteoporotic fractures; sex, age, prior fragility fracture and femoral neck BMD were significant independent predictors of hip fractures.
The Canadian FRAX tool provides predictions consistent with observed fracture rates in Canadian women and men, thereby providing a valuable tool for Canadian clinicians assessing patients at risk of fracture.
PubMed ID
21161508 View in PubMed
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Fragility fractures and the osteoporosis care gap in women: the Canadian Multicentre Osteoporosis Study.

https://arctichealth.org/en/permalink/ahliterature141740
Source
Osteoporos Int. 2011 Mar;22(3):789-96
Publication Type
Article
Date
Mar-2011
Author
L-A Fraser
G. Ioannidis
J D Adachi
L. Pickard
S M Kaiser
J. Prior
J P Brown
D A Hanley
W P Olszynski
T. Anastassiades
S. Jamal
R. Josse
D. Goltzman
A. Papaioannou
Author Affiliation
Departments of Epidemiology and Medicine, Hamilton Health Sciences-Chedoke Site, McMaster University, 1200 Main Street West, Hamilton, ON L8N3Z5, Canada.
Source
Osteoporos Int. 2011 Mar;22(3):789-96
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bone Density
Bone Density Conservation Agents - therapeutic use
Canada - epidemiology
Delivery of Health Care - trends
Diphosphonates - therapeutic use
Estrogen Replacement Therapy
Female
Fractures, Spontaneous - epidemiology - prevention & control
Guideline Adherence
Humans
Middle Aged
Osteoporosis, Postmenopausal - drug therapy - epidemiology
Osteoporotic Fractures - epidemiology - prevention & control
Physician's Practice Patterns - statistics & numerical data
Prospective Studies
Abstract
Canadian women over 50 years old were studied over a 10-year period to see if those who sustained a fracture (caused by minimal trauma) were receiving the recommended osteoporosis therapy. We found that approximately half of these women were not being treated, indicating a significant care gap in osteoporosis treatment.
Prevalent fragility fracture strongly predicts future fracture. Previous studies have indicated that women with fragility fractures are not receiving the indicated treatment. We aimed to describe post fracture care in Canadian women using a large, population-based prospective cohort that began in 1995-1997.
We followed 5,566 women over 50 years of age from across Canada over a period of 10 years in the Canadian Multicentre Osteoporosis Study. Information on medication use and incident clinical fragility fractures was obtained during a yearly questionnaire or interview and fractures were confirmed by radiographic/medical reports.
Over the 10-year study period, 42-56% of women with yearly incident clinical fragility fractures were not treated with an osteoporosis medication. During year 1 of the study, 22% of the women who had experienced a fragility fracture were on treatment with a bisphosphonate and 26% were on hormone therapy (HT). We were not able to differentiate HT use for menopause symptoms vs osteoporosis. Use of bisphosphonate therapy increased over time; odds ratio (OR) for use at year 10 compared to use at year 1 was 3.65 (95% confidence interval (CI) 1.83-7.26). In contrast, HT use declined, with an OR of 0.07 (95%CI 0.02-0.24) at year 10 compared to year 1 of the study.
In a large population-based cohort study, we found a therapeutic care gap in women with osteoporosis and fragility fractures. Although bisphosphonate therapy usage improved over time, a substantial gap remains.
PubMed ID
20683706 View in PubMed
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22 records – page 1 of 3.