title: Long-term effect of the Women's Health Initiative study on antiosteoporosis medication prescribing.
abstract: OBJECTIVE
  To describe long-term prescribing patterns of osteoporosis therapy before and after the Women's Health Initiative (WHI) publication.
  
  
  METHODS
  We conducted a time-series analysis from 1997 to 2005 using nationally representative data based on office-based physician and hospital ambulatory clinic visits. Bivariate and multivariable analyses were conducted using chi-square tests and logistic regression, respectively, and trends in the prevalence of osteoporosis therapies were evaluated per 6-month (semiannual) intervals. Linear regression and graphic techniques were used to determine statistical differences in the prevalence trends between the two periods.
  
  
  RESULTS
  Overall prevalence of therapeutic or preventive osteoporosis therapy was similar between the WHI periods. However, a significant decrease in estrogen therapy and increases in bisphosphonates, calcium/vitamin D were observed in the period after the WHI publication (p < 0.05). Multiple logistic regression analysis showed older age and white race were associated with a higher likelihood of antiosteoporosis medication (AOM) prescription, and Medicaid insurance type was associated with a lower likelihood of an AOM prescription. Excluding calcium/vitamin D, nonestrogen therapy was more likely to be prescribed in the after-WHI period (office-based physician clinic: [adjusted OR, aOR] 2.49 [2.04-4.04]; hospital-based clinic: aOR 2.42 [1.67-7.50]) Nonestrogen therapy was more prevalent in visits made by older women, women of white race, women with contraindicated conditions for estrogen therapy, and women from the Northeast region.
  
  
  CONCLUSIONS
  After the WHI publication, the overall prevalence of osteoporosis therapy did not change; however, a shift from estrogen to nonestrogen therapy was observed after the WHI publication. Black women were less likely to receive nonestrogen antiosteoporosis therapy in hospital-based clinics.
authors.affiliation: Department of Clinical and Administrative Pharmacy Sciences, School of Pharmacy, Howard University, Center for Minority Health Services Research, Washington, District of Columbia, USA. eunlee@chonnam.ac.kr
authors.forename: Euni
authors.initials: E
authors.lastname: Lee
authors.forename: Mary K
authors.initials: MK
authors.lastname: Maneno
authors.forename: Anthony K
authors.initials: AK
authors.lastname: Wutoh
authors.forename: Ilene H
authors.initials: IH
authors.lastname: Zuckerman
mesh_terms: D000328:Adult; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D016387:Women's Health; D014932:Women's Health Services; D055815:Young Adult
chemical_list: D050071:Bone Density Conservation Agents
references.citation: Eur J Clin Pharmacol. 2007 Sep;63(9):843-9
references.pmid: 17598097
references.citation: Adv Data. 2007 Jun 29;(387):1-39
references.pmid: 17703793
references.citation: Endocr Pract. 2003 Nov-Dec;9(6):544-64
references.pmid: 14715483
references.citation: Adv Data. 2007 Jun 29;(389):1-34
references.pmid: 17784724
references.citation: Osteoporos Int. 2006;17(3):395-404
references.pmid: 16314982
references.citation: J Gen Intern Med. 1999 Nov;14(11):663-9
references.pmid: 10571714
references.citation: Arch Intern Med. 2002 Nov 11;162(20):2362-6
references.pmid: 12418951
references.citation: Osteoporos Int. 2008 Nov;19(11):1603-12
references.pmid: 18373048
references.citation: Maturitas. 2007 Feb 20;56(2):129-41
references.pmid: 16901660
references.citation: Obstet Gynecol. 1999 Jun;93(6):999-1003
references.pmid: 10362170
references.citation: JAMA. 2004 Jan 7;291(1):47-53
references.pmid: 14709575
references.citation: Arch Intern Med. 2004 Jul 26;164(14):1525-30
references.pmid: 15277283
references.citation: BMC Public Health. 2007 Apr 17;7:56
references.pmid: 17439639
references.citation: Eur J Clin Pharmacol. 2006 Apr;62(4):307-10
references.pmid: 16432715
references.citation: Am J Med. 2003 Aug 15;115(3):209-16
references.pmid: 12947959
references.citation: Menopause. 2006 Jan-Feb;13(1):125-9
references.pmid: 16607108
references.citation: Pharmacoepidemiol Drug Saf. 2005 Dec;14(12):837-42
references.pmid: 15812877
references.citation: J Womens Health (Larchmt). 2006 Mar;15(2):155-61
references.pmid: 16536679
references.citation: Pharmacotherapy. 2004 Apr;24(4):495-9
references.pmid: 15098804
references.citation: Pharmacoepidemiol Drug Saf. 2005 Mar;14(3):171-6
references.pmid: 15386701
references.citation: JAMA. 2002 Jul 17;288(3):321-33
references.pmid: 12117397
references.citation: BJOG. 2006 Jan;113(1):15-20
references.pmid: 16398765
references.citation: Prev Med. 2001 Dec;33(6):668-73
references.pmid: 11716665
references.citation: Curr Med Res Opin. 2008 Jan;24(1):207-13
references.pmid: 18042311
references.citation: Menopause. 2008 Jul-Aug;15(4 Pt 1):584-602
references.pmid: 18580541
references.citation: Osteoporos Int. 2003 May;14(3):259-62
references.pmid: 12730745
references.citation: Osteoporos Int. 2003 Dec;14(12):965-8
references.pmid: 14504697
references.citation: J Bone Miner Res. 2006 May;21(5):765-71
references.pmid: 16734392
references.citation: Osteoporos Int. 2003 Oct;14(10):808-13
references.pmid: 14523610
references.citation: Osteoporos Int. 2008 Jul;19(7):1047-54
references.pmid: 18373055
references.citation: Aging Clin Exp Res. 2005 Apr;17(2):143-9
references.pmid: 15977463
references.citation: Maturitas. 2004 Jul 15;48(3):271-87
references.pmid: 15207894
references.citation: Am J Health Syst Pharm. 2005 Jan 1;62(1):69-74
references.pmid: 15658075
references.citation: Ann Intern Med. 2004 Feb 3;140(3):184-8
references.pmid: 14757616
references.citation: J Womens Health (Larchmt). 2004 Nov;13(9):986-92
references.pmid: 15665655
references.citation: JAMA. 2004 Oct 27;292(16):1983-8
references.pmid: 15507584
references.citation: Arch Gynecol Obstet. 2008 Mar;277(3):219-24
references.pmid: 17713777