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Biological, social, and environmental correlates of preschool development.

https://arctichealth.org/en/permalink/ahliterature195378
Source
Child Care Health Dev. 2001 Mar;27(2):187-200
Publication Type
Article
Date
Mar-2001
Author
T. To
S M Cadarette
Y. Liu
Author Affiliation
Population Health Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada. teresa.to@sickkids.on.ca
Source
Child Care Health Dev. 2001 Mar;27(2):187-200
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Birth weight
Canada - epidemiology
Child, Preschool
Cross-Sectional Studies
Developmental Disabilities - epidemiology
Female
Health status
Humans
Infant
Infant, Newborn
Logistic Models
Male
Odds Ratio
Parents - psychology
Risk factors
Social Environment
Socioeconomic Factors
Abstract
Baseline data from the Canadian National Longitudinal Survey of Children and Youth (NLSCY, a population-based study of child health, development and well-being), were used to determine biological, social and environmental correlates of poor development among preschool children. A total weighted sample of 1233 500 (n = 6982 unweighted) children aged from birth to 3 years were studied. Developmental attainment was measured by the motor, social and development (MSD) scale. Children scoring amongst the lowest 15% for their age group were categorized as having poor developmental attainment (PDA). Correlates of PDA were determined using logistic regression. The MSD scale may not be discriminatory enough to identify PDA in children aged
PubMed ID
11251617 View in PubMed
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Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature134290
Source
Osteoporos Int. 2012 Mar;23(3):1075-82
Publication Type
Article
Date
Mar-2012
Author
A M Burden
J M Paterson
D H Solomon
M. Mamdani
D N Juurlink
S M Cadarette
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON, Canada M5S 3M2.
Source
Osteoporos Int. 2012 Mar;23(3):1075-82
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Aged, 80 and over
Bone Density Conservation Agents - administration & dosage - therapeutic use
Diphosphonates - administration & dosage - therapeutic use
Drug Prescriptions - statistics & numerical data
Drug Substitution - statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Medication Adherence - statistics & numerical data
Ontario
Osteoporosis - drug therapy - psychology
Osteoporosis, Postmenopausal - drug therapy - psychology
Physician's Practice Patterns - statistics & numerical data
Time Factors
Abstract
We studied new users of oral bisphosphonates and found that less than half persisted with therapy for 2 years, and interruptions in use were common. During a median observation period of 4.7 years, 10% of patients filled only a single prescription, 37% switched therapies and median cumulative exposure was 2.2 years.
We sought to describe bisphosphonate prescribing, persistence and cumulative exposure among seniors in Ontario, Canada.
We used Ontario Drug Benefit pharmacy claims to identify residents aged = 66 years who initiated oral bisphosphonate therapy between April 1996 and March 2009. The first date of bisphosphonate dispensing was considered the index date. Persistence with therapy was defined as continuous treatment with no interruption exceeding 60 days. We examined persistence with therapy and the number of extended gaps (>60 days) between prescriptions over time periods ranging from 1 to 9 years. We also identified the proportion of patients filling only a single prescription and switching to a different bisphosphonate, and calculated the median days of exposure irrespective of gaps in therapy.
A total of 451,113 eligible new bisphosphonate users were identified: mean age = 75.6 years (SD = 6.9), 84% female, and median follow-up length = 4.7 years. Persistence with therapy declined from 63% at 1 year to 46% at 2 years and 12% at 9 years. Among those with at least 5 years of follow-up (n = 213,029), 61% had one or more extended gaps in bisphosphonate therapy. Overall, 10% of patients filled only a single prescription, 37% switched to a different bisphosphonate and the median exposure was 2.2 years.
Less than half of patients persisted with bisphosphonate therapy for 2 years and interruptions in therapy were common, with most patients experiencing two or more >60-day gaps in therapy. Interventions are needed to improve persistence with bisphosphonate therapy and reduce the frequency of gaps in treatment.
Notes
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PubMed ID
21604008 View in PubMed
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Child care arrangement and preschool development.

https://arctichealth.org/en/permalink/ahliterature195801
Source
Can J Public Health. 2000 Nov-Dec;91(6):418-22
Publication Type
Article
Author
T. To
S M Cadarette
Y. Liu
Author Affiliation
Population Health Sciences, Research Institute, Hospital for Sick Children, Toronto.
Source
Can J Public Health. 2000 Nov-Dec;91(6):418-22
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Child Care - methods - organization & administration - standards
Child Day Care Centers - utilization
Child Development
Child, Preschool
Female
Humans
Longitudinal Studies
Male
Parent-Child Relations
Parenting
Socialization
Socioeconomic Factors
Abstract
Baseline data from the Canadian National Longitudinal Survey of Children and Youth were used to evaluate the associations between child care arrangement and poor developmental attainment (PDA). A weighted total of 521,800 children aged 2 to 3 years were studied (N = 2,709). PDA was assessed by age-standardized motor and social development score. Children were grouped by the predominant type of arrangement: care by someone in the child's own home, in another home (family child care), at a child care centre, or none (child care exclusive to parents). Controlling for socioeconomic status, biological factors and maternal immigration, family dysfunction, hostile parenting and low neighbourhood safety were correlated with PDA and positive parent-child interaction decreased the odds of PDA. Whereas centre child care arrangements were beneficial to development overall (OR = 0.41, 99% CI = 0.18, 0.93), an interaction existed between type of child care and maternal depression; among children with depressed mothers, centre child care was associated with increased odds of PDA. Findings suggest that the associations between child care arrangement and child development involve interactions of factors that influence a child's home environment. Future child development studies exploring these interactions are warranted.
PubMed ID
11200730 View in PubMed
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Development and validation of the Osteoporosis Risk Assessment Instrument to facilitate selection of women for bone densitometry.

https://arctichealth.org/en/permalink/ahliterature198608
Source
CMAJ. 2000 May 2;162(9):1289-94
Publication Type
Article
Date
May-2-2000
Author
S M Cadarette
S B Jaglal
N. Kreiger
W J McIsaac
G A Darlington
J V Tu
Author Affiliation
Canadian Multicentre Osteoporosis Study, University of Toronto, Ont. s.cadarette@utoronto.ca
Source
CMAJ. 2000 May 2;162(9):1289-94
Date
May-2-2000
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Aged
Algorithms
Canada
Cohort Studies
Female
Humans
Mass Screening
Middle Aged
Osteoporosis, Postmenopausal - diagnosis - etiology
Patient Selection
Reproducibility of Results
Risk assessment
Abstract
Although mass screening for osteoporosis is not recommended among postmenopausal women, there is no consensus on which women should undergo testing for low bone mineral density. The objective of this study was to develop and validate a clinical tool to help clinicians identify which women are at increased risk for osteoporosis and should therefore undergo further testing with bone densitometry.
Using Ontario baseline data from the Canadian Multicentre Osteoporosis Study, we identified all cognitively normal women aged 45 years or more who had undergone testing with dual-energy x-ray absorptiometry (DXA) at both the femoral neck and the lumbar spine (L1-L4). Participants who had a previous diagnosis of osteoporosis or were taking bone active medication other than ovarian hormones were excluded. The main outcome measure was low bone mineral density (T score of 2 or more standard deviations below the mean for young Canadian women) at either the femoral neck or the lumbar spine. Logistic regression analysis and receiver operating characteristic (ROC) analysis were used to identify the simplest algorithm that would identify women at increased risk for low bone mineral density.
The study population comprised 1376 women, of whom 926 were allocated to the development of the tool and 450 to its validation. A simple algorithm based on age, weight and current estrogen use (yes or no) was developed. Validation of this 3-item Osteoporosis Risk Assessment Instrument (ORAI) showed that the tool had a sensitivity of 93.3% (95% confidence interval [CI] 86.3%-97.0%) and a specificity of 46.4% (95% CI 41.0%-51.8%) for selecting women with low bone mineral density. The sensitivity of the instrument for selecting women with osteoporosis was 94.4% (95% CI 83.7%-98.6%). Use of the ORAI represented a 38.7% reduction in DXA testing compared with screening all women in our study.
The ORAI accurately identifies the vast majority of women likely to have low bone mineral density and is effective in substantially decreasing the need for all women to undergo DXA testing.
Notes
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PubMed ID
10813010 View in PubMed
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Development of an integrated-care delivery model for post-fracture care in Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature168468
Source
Osteoporos Int. 2006;17(9):1337-45
Publication Type
Article
Date
2006
Author
S B Jaglal
C. Cameron
G A Hawker
J. Carroll
L. Jaakkimainen
S M Cadarette
E R Bogoch
H. Kreder
D. Davis
Author Affiliation
Department of Physical Therapy, University of Toronto, 160-500 University Ave., Toronto, ON, M5G 1V7, Canada. susan.jaglal@utoronto.ca
Source
Osteoporos Int. 2006;17(9):1337-45
Date
2006
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Continuity of Patient Care - organization & administration
Delivery of Health Care, Integrated - organization & administration
Focus Groups
Fractures, Bone - etiology - prevention & control
Health Services Research
Humans
Interprofessional Relations
Models, organizational
Ontario
Osteoporosis - complications - diagnosis - therapy
Patient Education as Topic
Referral and Consultation - organization & administration
Abstract
The purpose of this study was to develop an integrated-care model for patients at highest risk for osteoporosis, those with a low-trauma fracture. Specific objectives were to describe the current processes and patterns of post-fracture care in hospitals in Ontario; to examine health-care professional and patient awareness of osteoporosis and the roles and responsibilities of various organizations and health care professionals; and to identify barriers and facilitators and obtain feedback on the model.
In 2002, questionnaires were completed for 178 eligible hospitals.
Only 65% of hospitals inform primary-care physicians of a fracture for all patients and only 4% indicated that they provide information about osteoporosis. The main themes that emerged from the four patient focus groups (n=21) were lack of continuity of care, the absence of a link between the fracture and osteoporosis by both patients and health care providers, and need for information. Most participants agreed that something was needed to prompt their primary-care physician to investigate for osteoporosis. The four physician focus groups (n=26) identified a role for orthopaedic surgeons to flag cases.
From 34 key informant interviews with community-based organizations, we found a lack of integration between health care professionals who provide fracture care and those who provide osteoporosis management and fall prevention. Based on these data, we developed an integrated local-resource-based post-fracture care model, which we obtained feedback on at a stakeholder consultation workshop. The model focuses on improving emergency department/fracture clinic communication, emphasizes the need for follow-up investigation by family physicians for osteoporosis, and incorporates other health care professionals and a telemedicine multidisciplinary osteoporosis clinic. We are currently evaluating whether this model leads to an increase in appropriate investigation of and treatment for osteoporosis in patients with low-trauma fractures.
PubMed ID
16821001 View in PubMed
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Direct health-care costs attributed to hip fractures among seniors: a matched cohort study.

https://arctichealth.org/en/permalink/ahliterature123075
Source
Osteoporos Int. 2013 Feb;24(2):659-69
Publication Type
Article
Date
Feb-2013
Author
M. Nikitovic
W P Wodchis
M D Krahn
S M Cadarette
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON, M5S 3M2, Canada.
Source
Osteoporos Int. 2013 Feb;24(2):659-69
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Cohort Studies
Female
Health Care Costs - statistics & numerical data
Health Resources - utilization
Health Services Research - methods
Hip Fractures - economics - epidemiology - therapy
Humans
Male
Ontario - epidemiology
Osteoporotic Fractures - economics - epidemiology - therapy
Prognosis
Sex Distribution
Sex Factors
Survival Analysis
Treatment Outcome
Abstract
Using a matched cohort design, we estimated the mean direct attributable cost in the first year after hip fracture in Ontario to be $36,929 among women and $39,479 among men. These estimates translate into an annual $282 million in direct attributable health-care costs in Ontario and $1.1 billion in Canada.
Osteoporosis is a major public health concern that results in substantial fracture-related morbidity and mortality. It is well established that hip fractures are the most devastating consequence of osteoporosis, yet the health-care costs attributed to hip fractures in Canada have not been thoroughly evaluated.
We determined the 1- and 2-year direct attributable costs and cost drivers associated with hip fractures among seniors in comparison to a matched non-hip fracture cohort using health-care administrative data from Ontario (2004-2008). Entry into long-term care and deaths attributable to hip fracture were also determined.
We successfully matched 22,418 female (mean age?=?83.3 years) and 7,611 male (mean age?=?81.3 years) hip fracture patients. The mean attributable cost in the first year after fracture was $36,929 (95 % CI $36,380-37,466) among women and $39,479 (95 % CI $38,311-$40,677) among men. These estimates translate into an annual $282 million in direct attributable health-care costs in Ontario and $1.1 billion in Canada. Primary cost drivers were acute and post-acute institutional care. Approximately 24 % of women and 19 % of men living in the community at the time of fracture entered a long-term care facility, and 22 % of women and 33 % of men died within the first year following hip fracture. Attributable costs remained elevated into the second year ($9,017 among women, $10,347 among men) for patients who survived the first year.
We identified significant health-care costs, entry into long-term care, and mortality attributed to hip fractures. Results may inform health economic analyses and policy decision-making in Canada.
Notes
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PubMed ID
22736067 View in PubMed
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Impact of a centralized osteoporosis coordinator on post-fracture osteoporosis management: a cluster randomized trial.

https://arctichealth.org/en/permalink/ahliterature132786
Source
Osteoporos Int. 2012 Jan;23(1):87-95
Publication Type
Article
Date
Jan-2012
Author
S B Jaglal
O S Donescu
V. Bansod
J. Laprade
K. Thorpe
G. Hawker
S R Majumdar
L. Meadows
S M Cadarette
A. Papaioannou
M. Kloseck
D. Beaton
E. Bogoch
M. Zwarenstein
Author Affiliation
Toronto Rehabilitation Institute, Toronto, ON, Canada. susan.jaglal@utoronto.ca
Source
Osteoporos Int. 2012 Jan;23(1):87-95
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Bone Density Conservation Agents - therapeutic use
Case Management - organization & administration
Delivery of Health Care, Integrated - organization & administration
Drug Utilization - statistics & numerical data
Emergency Service, Hospital
Female
Humans
Male
Middle Aged
Ontario
Osteoporosis - diagnosis - drug therapy
Osteoporotic Fractures - prevention & control
Outcome Assessment (Health Care)
Primary Health Care - organization & administration
Sex Factors
Abstract
We conducted a cluster randomized trial evaluating the effect of a centralized coordinator who identifies and follows up with fracture patients and their primary care physicians about osteoporosis. Compared with controls, intervention patients were five times more likely to receive BMD testing and two times more likely to receive appropriate management.
To determine if a centralized coordinator who follows up with fracture patients and their primary care physicians by telephone and mail (intervention) will increase the proportion of patients who receive appropriate post-fracture osteoporosis management, compared to simple fall prevention advice (attention control).
A cluster randomized controlled trial was conducted in small community hospitals in the province of Ontario, Canada. Hospitals that treated between 60 and 340 fracture patients per year were eligible. Patients 40 years and older presenting with a low trauma fracture were identified from Emergency Department records and enrolled in the trial. The primary outcome was 'appropriate' management, defined as a normal bone mineral density (BMD) test or taking osteoporosis medications.
Thirty-six hospitals were randomized to either intervention or control and 130 intervention and 137 control subjects completed the study. The mean age of participants was 65 ± 12 years and 69% were female. The intervention increased the proportion of patients who received appropriate management within 6 months of fracture; 45% in the intervention group compared with 26% in the control group (absolute difference of 19%; adjusted OR, 2.3; 95% CI, 1.3-4.1). The proportion who had a BMD test scheduled or performed was much higher with 57% of intervention patients compared with 21% of controls (absolute difference of 36%; adjusted OR, 4.8; 95% CI, 3.0-7.0).
A centralized osteoporosis coordinator is effective in improving the quality of osteoporosis care in smaller communities that do not have on-site coordinators or direct access to osteoporosis specialists.
Notes
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PubMed ID
21779817 View in PubMed
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Osteoporosis medication prescribing in British Columbia and Ontario: impact of public drug coverage.

https://arctichealth.org/en/permalink/ahliterature131481
Source
Osteoporos Int. 2012 Apr;23(4):1475-80
Publication Type
Article
Date
Apr-2012
Author
S M Cadarette
G. Carney
D. Baek
N. Gunraj
J M Paterson
C R Dormuth
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, M5S 3M2, ON, Canada. s.cadarette@utoronto.ca
Source
Osteoporos Int. 2012 Apr;23(4):1475-80
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Aged
Bone Density Conservation Agents - therapeutic use
British Columbia
Diphosphonates - therapeutic use
Drug Prescriptions - statistics & numerical data
Drug Utilization - statistics & numerical data - trends
Female
Humans
Insurance Coverage
Male
Ontario
Osteoporosis - drug therapy
Osteoporosis, Postmenopausal - drug therapy
Physician's Practice Patterns - statistics & numerical data - trends
Sex Factors
State Medicine - statistics & numerical data
Abstract
We compared the patterns of osteoporosis medication prescribing between two provinces in Canada with different public drug coverage policies. Oral bisphosphonates were the primary drugs used, yet access to the second-generation oral bisphosphonates (alendronate, risedronate) was limited in one region. Implications of differential access to oral bisphosphonates warrants further study.
Approved therapies for treating osteoporosis in Canada include bisphosphonates, calcitonin, denosumab, raloxifene, and teriparatide. However, significant variation in access to these medications through public drug coverage exists across Canada. We sought to compare patterns of osteoporosis medication prescribing between British Columbia (BC) and Ontario.
Using dispensing data from BC (PharmaNet) and Ontario (Ontario Drug Benefits), we identified all new users of osteoporosis medications aged 66 or more years from 1995/1996 to 2008/2009. We summarized the number of new users by fiscal year, sex, and index drug for each province. BC data were also stratified by whether drugs were dispensed within or outside public PharmaCare.
We identified 578,254 (n?=?122,653 BC) eligible new users. Overall patterns were similar between provinces: (1) most patients received an oral bisphosphonate (93% in BC and 99% in Ontario); (2) etidronate prescribing declined after 2001/2002, reaching a low of 41% in BC and 10% in Ontario in 2008/2009; and (3) the proportion of males treated increased over time, from 7% in 1996/1997 to 25% in 2008/2009. However, we note major differences within versus outside the BC PharmaCare system. In particular,
Notes
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PubMed ID
21901476 View in PubMed
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Osteoporosis pharmacotherapy following bone densitometry: importance of patient beliefs and understanding of DXA results.

https://arctichealth.org/en/permalink/ahliterature141741
Source
Osteoporos Int. 2011 May;22(5):1493-501
Publication Type
Article
Date
May-2011
Author
D. Brask-Lindemann
S M Cadarette
P. Eskildsen
B. Abrahamsen
Author Affiliation
Department of Endocrinology, Copenhagen University Hospital, Køge, Denmark. dbr@regionsjaelland.dk
Source
Osteoporos Int. 2011 May;22(5):1493-501
Date
May-2011
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Aged
Bone Density Conservation Agents - administration & dosage - therapeutic use
Correspondence as Topic
Denmark
Drug Administration Schedule
Family Practice
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Medication Adherence - statistics & numerical data
Middle Aged
Osteoporosis - diagnosis - drug therapy
Patient Education as Topic - methods
Referral and Consultation
Self Disclosure
Abstract
Persistence with osteoporosis therapy remains low and identification of factors associated with better persistence is essential in preventing osteoporosis and fractures. In this study, patient understanding of dual energy X-ray absorptiometry (DXA) results and beliefs in effects of treatment were associated with treatment initiation and persistence.
The purpose of this study is to examine patient understanding of their DXA results and evaluate factors associated with initiation of and persistence with prescribed medication in first-time users of anti-osteoporotic agents. Self-reported DXA results reflect patient understanding of diagnosis and may influence acceptance of osteoporosis therapy. To improve patient understanding of DXA results, we provided written information to patients and their referring general practitioner (GP), and evaluated factors associated with osteoporosis treatment initiation and 1-year persistence.
Information on diagnosis was mailed to 1,000 consecutive patients and their GPs after DXA testing. One year after, a questionnaire was mailed to all patients to evaluate self-report of DXA results, drug initiation and 1-year persistence. Quadratic weighted kappa was used to estimate agreement between self-report and actual DXA results. Multivariable logistic regression was used to evaluate predictors of understanding of diagnosis, and correlates of treatment initiation and persistence.
A total of 717 patients responded (72%). Overall, only 4% were unaware of DXA results. Agreement between self-reported and actual DXA results was very good (??=?0.83); younger age and glucocorticoid use were associated with better understanding. Correctly reported DXA results was associated with treatment initiation (OR 4.3, 95% CI 1.2-15.1, p?=?0.02), and greater beliefs in drug treatment benefits were associated with treatment initiation (OR 1.4, 95%CI 1.1-1.9, p?=?0.006) and persistence with therapy (OR 1.8, 95% CI 1.2-2.7, p?=?0.006).
Our findings suggest that written information provides over 80% of patients with a basic understanding of their DXA results. Communicating results in writing may improve patient understanding thereby also improve osteoporosis management and prevention.
PubMed ID
20683704 View in PubMed
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Osteoporosis quality indicators using healthcare utilization data.

https://arctichealth.org/en/permalink/ahliterature142610
Source
Osteoporos Int. 2011 May;22(5):1335-42
Publication Type
Article
Date
May-2011
Author
S M Cadarette
S B Jaglal
L. Raman-Wilms
D E Beaton
J M Paterson
Author Affiliation
Leslie Dan Faculty of Pharmacy, University of Toronto, Leslie L. Dan Pharmacy Building, 144 College Street, Toronto, ON M5S 3M2, Canada. s.cadarette@utoronto.ca
Source
Osteoporos Int. 2011 May;22(5):1335-42
Date
May-2011
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon - utilization
Aged
Aged, 80 and over
Bone Density
Bone Density Conservation Agents - administration & dosage
Drug Utilization - statistics & numerical data
Female
Humans
Ontario
Osteoporosis, Postmenopausal - drug therapy - physiopathology - radiography
Osteoporotic Fractures - etiology - prevention & control
Quality Indicators, Health Care
Risk factors
Self Disclosure
Sensitivity and specificity
Abstract
Healthcare utilization data may be used to examine the quality of osteoporosis management by identifying dual-energy X-ray absorptiometry (DXA) testing (sensitivity?=?98%, specificity?=?93%) and osteoporosis pharmacotherapy (??=?0.81) with minimal measurement error.
In osteoporosis, key quality indicators among older women include risk assessment by DXA and/or pharmacotherapy within 6 months following fracture.
The purpose of this study was to examine healthcare utilization data for use as quality indicators of osteoporosis management. We linked data from 858 community-dwelling women aged over 65 years who completed a standardized telephone interview about osteoporosis management to their healthcare utilization (medical and pharmacy claims) data. Agreement between self-report of osteoporosis pharmacotherapy and pharmacy claims was examined using kappa statistics. We examined the sensitivity and specificity of medical claims to identify DXA testing as well as the sensitivity and specificity of medical and pharmacy claims to identify those with DXA-documented osteoporosis (T-score?=?-2.5).
Participants were aged 75 (SD?=?6)?years on average; 96% were Caucasian. Agreement between self-report and claims-based osteoporosis pharmacotherapy was very good (??=?0.81; 95% CI?=?0.76, 0.86). The sensitivity of medical claims to identify DXA testing was 98% (95% CI?=?95.9, 99.1), with estimated specificity of 93% (95% CI?=?89.8, 95.4). We abstracted DXA results from test reports of 359 women, of whom 114 (32%) were identified with osteoporosis. Medical (osteoporosis diagnosis) and pharmacy (osteoporosis pharmacotherapy) claims within a year after DXA testing had a sensitivity of 80% (95% CI?=?71.3, 86.8) and specificity of 72% (95% CI?=?66.2, 77.8) to identify DXA-documented osteoporosis.
Healthcare utilization data may be used to examine the quality of osteoporosis management by identifying DXA testing and osteoporosis pharmacotherapy (care processes) with minimal measurement error. However, medical and pharmacy claims alone do not provide a good means for identifying women with underlying osteoporosis.
Notes
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PubMed ID
20577872 View in PubMed
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