title: Racial variations in antiresorptive medication use: results from the 2000 Medical Expenditure Panel Survey (MEPS).
abstract: Although a number of studies have examined racial variation in antiresorptive medication use, those studies are limited to generalizing beyond the use of hormone therapy (HT), geographic region, and black ethnicity. Our primary aims were (1) to describe variation in the use of antiresorptive medications among US women of different ethnicities aged 45 years and older in the year 2000 and (2) to understand the association between ethnicity and antiresorptive medication use after adjustment for other factors that might have had an impact on use. The data source used in this study was the 2000 Medical Expenditure Panel Survey. Using a modified health services utilization model we performed hierarchical multivariate logistic regression analyses to examine the relationship between race and antiresorptive medication use. The use of HT among blacks, Hispanics, and other ethnicities was significantly less than among whites. This relationship was significant, even after we had controlled for predisposing, enabling, and need characteristics. The use of newer antiresorptive medications (bisphosphonates, raloxifene, and nasal calcitonin) also was less common among racial minorities than among whites. However, controlling for predisposing characteristics of education, income, census region, and age eliminated differences in use between Hispanics and whites. Controlling for need characteristics of health status, osteoporosis, and predisposing illnesses eliminated differences in antiresorptive use between blacks and whites. Significant differences in the use of newer antiresorptives remained between other ethnicities and whites, even in the fully specified model. The results of this study suggest that ethnicity is a significant predictor of the use of both HT and newer antiresorptive medication. These results also suggest that a number of variables are important in explaining racial differences in antiresorptive use, particularly among users of newer antiresorptive medications.
authors.affiliation: Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, 7-170 Weaver-Densford Hall, 308 Harvard St. S.E., Minneapolis, MN 55455, USA. farl0032@umn.edu
authors.forename: Joel F
authors.initials: JF
authors.lastname: Farley
authors.forename: Richard R
authors.initials: RR
authors.lastname: Cline
authors.forename: Kiran
authors.initials: K
authors.lastname: Gupta
mesh_terms: D001741:Black or African American; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001862:Bone Resorption / Q000188:drug therapy; D004522:Educational Status; D015914:Estrogen Replacement Therapy; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000208:ethnology* / Q000517:prevention & control*; D018579:Patient Selection; D044469:Racial Groups; D012923:Social Class; D014481:United States; D044465:White People
chemical_list: D050071:Bone Density Conservation Agents