[Incidence of hip fractures due to osteoporosis in relation to the prescription of drugs for their prevention and treatment in Galicia, Spain].
OBJECTIVE
To analyse the evolution in the incidence of hip fractures in our autonomous community in relationship to the trend in the prescription of medicines for the prevention and/or treatment of osteoporotic hip fracture.


METHODS
Descriptive observational ecological study.


METHODS
Public health network in the whole autonomous community over five years, from 1st January 2004 to 31st December 2008.


METHODS
Patients over 44 years old admitted with osteoporotic hip fracture. Medicines dispensed at a pharmacy which are indicated for the prevention of osteoporotic hip fractures (alendronate, risedronate and strontium ranelate). Exclusion: Open fractures, hospital or private or prescriptions.


METHODS
Incidence (number of new cases of hip fractures occurring in a year), Incidence rate (incidence per 100,000 inhabitants), Dispersion rate (number of packets dispensed per year per 100,000 inhabitants) and Hazard ratio (HR, ratio between the rate of last year and first). Annual rates were calculated standardised by the direct method.


RESULTS
We identified 12,137 hospital admissions for fractured hip (2,792 men and 9,345 women). Sub-capital fractures: Mean Incidence Rate (MIR)=86.14,95%CI[61.85-110.42]; HR=1.22, 95%CI[0.82-1.63] (men) and MIR=180.88,95%CI[124.74-237.02]; HR=1.08,95%CI[0.73-1.43] (women). Trochanteric fractures: MIR=56.30,95%CI[39.18-73.42], HR=1.04,95%CI[0.75-1.34] (men) and MIR=136.51,95%CI[90.23-182.78]; HR=1.12,95%CI[0.89-1.35] (women). Subtrochanteric fractures: MIR=8.92,95%CI[6.52-11.32]; HR=1.26,95%CI[0.05-2.46] (men) and MIR=22.91,95%CI[15.24-30.58]; HR=1.08,95%CI[0.57-1.58] (women). Total HR fractures=1.07, 95%CI[0.92-1.23] (men) and 0.99,95%CI[0.83-1.17] (women). Drug dispensing (2008-2004): HR alendronate=1.30; HR risedronate=1.92; HR strontium ranelate=10.38.


CONCLUSIONS
Over five years the dispensing of drugs by the public health service has multiplied for the prevention and treatment of hip fractures while the incidence has remained unaltered.
Guerra-García
María Mercedes
MM
Centro de Saúde de Porriño, Xerencia de Atención Primaria de Vigo, Porriño, Pontevedra, Galicia, España. maria.mercedes.guerra.garcia@sergas.es
Rodríguez-Fernández
José Benito
JB
Puga-Sarmiento
Elías
E
Charle-Crespo
María Ángeles
MÁ
Gomes-Carvalho
Claudia Sofía
CS
Prejigueiro-Santás
Ana
A
D000368:Aged; D019386:Alendronate / Q000627:therapeutic use*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006620:Hip Fractures / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D058866:Osteoporotic Fractures / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D000068296:Risedronic Acid; D013030:Spain; D013876:Thiophenes / Q000627:therapeutic use*
D050071:Bone Density Conservation Agents; D009942:Organometallic Compounds; D013876:Thiophenes; C081587:strontium ranelate; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate