Effect of the women's health initiative on prescription anti-osteoporosis medication utilization.
Publication of the Women's Health Initiative (WHI) resulted in a 39% reduction in hormone therapy utilization and a 29% increase in the use of new anti-osteoporosis medications. Overall, the prevalence of prescription anti-osteoporosis medication use declined following the WHI. This has important implications for osteoporosis prevention and treatment.


BACKGROUND
Women who discontinued hormone therapy (HT) following the Women's Health Initiative (WHI) may have been more likely to initiate treatment with newer anti-osteoporosis medications (AOM). The objective of this study was to examine the influence of the WHI on AOM utilization among a nationally representative sample of older adult women in the U.S.


METHODS
We used the Medical Expenditure Panel Survey (MEPS) to examine AOM utilization among women aged 50 years and older. National estimates of AOM utilization were predicted from a sample of 2089 women interviewed five times between 2002 and 2003. AOM utilization was dichotomized for HT and newer AOM. Generalized estimating equations were used to predict odds ratios (OR) for AOM utilization controlling for potential predisposing, enabling, and need confounders.


RESULTS
Prior to the WHI, there were 8.7 and 3.6 million U.S. women using HT and newer AOM, respectively. One year following publication of the WHI, 5.3 million HT users persisted [OR 0.638 (95% CI: 0.617, 0.756)] while 4.7 million women used newer AOM [1.337 (95% CI: 1.120, 1.597)].


CONCLUSIONS
Although reductions in HT utilization were accompanied by increased utilization of newer AOM, treatment prevalence for osteoporosis remains sub-optimal.
Farley
J F
JF
Division of Pharmaceutical Outcomes and Policy, University of North Carolina School of Pharmacy, CB #7360, 2201 Kerr Hall, Chapel Hill, NC 27599-7360, USA. jffarley@unc.edu
Blalock
S J
SJ
Cline
R R
RR
D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000706:statistics & numerical data; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D055553:Prescription Drugs / Q000627:therapeutic use*; D012959:Socioeconomic Factors; D014481:United States; D016387:Women's Health
D050071:Bone Density Conservation Agents; D055553:Prescription Drugs