Undertreatment of osteoporosis in residents of nursing homes: population-based study with use of the Systematic Assessment of Geriatric Drug Use via Epidemiology (SAGE) database.
OBJECTIVE
To determine the proportion of nursing home residents >65 years of age with osteoporosis who were receiving antiosteoporosis pharmacotherapy and to identify the predictors of administration of such drugs.


METHODS
We identified 29,357 patients with osteoporosis documented on the Minimum Data Set collected on residents of all nursing home facilities in 5 states during the period from 1992 through 1996. A multiple logistic regression model was used for analysis, with the dependent variable being use of any antiosteoporosis drug.


RESULTS
Among the nursing home residents with osteoporosis, 25% received antiosteoporosis drugs. Women were more likely than men to receive antiosteoporosis drugs (adjusted odds ratio [OR], 1.41; 95% confidence interval [CI], 1.26 to 1.57). Both increasing age and level of cognitive impairment were inversely related to receipt of antiosteoporosis drugs. A history of fracture or falls was not predictive of use of such drugs. Treatment was less likely for nursing home residents with > or = 6 medical conditions (OR 0.55, 95% CI 0.51 to 0.59); those admitted to a nursing home from a hospital (OR 0.86, 95% Cl 0.80 to 0.92); and those with a terminal prognosis (OR 0.60,95% CI 0.42 to 0.87).


CONCLUSIONS
The majority of nursing home residents with osteoporosis in this study did not receive drug therapy for this disabling and treatable disease. Although acceptable reasons may exist in some of these residents,others--especially the oldest old--may not be receiving adequate care.
Rojas-Fernandez
Carlos H
CH
Texas Tech University-Health Sciences Center-Amarillo, School of Pharmacy, 79106, USA.
Lapane
Kate L
KL
MacKnight
Chris
C
Howard
Kellee A
KA
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002118:Calcium / Q000008:administration & dosage; D003072:Cognition Disorders; D019992:Databases as Topic; D004164:Diphosphonates / Q000008:administration & dosage; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009735:Nursing Homes; D016017:Odds Ratio; D010024:Osteoporosis / Q000188:drug therapy* / Q000453:epidemiology*; D011379:Prognosis; D012737:Sex Factors
D004164:Diphosphonates; D004967:Estrogens; D002118:Calcium