title: Regional differences in treatment for osteoporosis. The Global Longitudinal Study of Osteoporosis in Women (GLOW).
abstract: OBJECTIVE
  To determine if important geographic differences exist in treatment rates for osteoporosis and whether this variation can be explained by regional variation in risk factors.
  
  
  METHODS
  The Global Longitudinal Study of Osteoporosis in Women is an observational study of women ≥55 years sampled from primary care practices in 10 countries. Self-administered questionnaires were used to collect data on patient characteristics, risk factors for fracture, previous fractures, anti-osteoporosis medication, and health status.
  
  
  RESULTS
  Among 58,009 women, current anti-osteoporosis medication use was lowest in Northern Europe (16%) and highest in U.S.A. and Australia (32%). Between 48% (U.S.A., Southern Europe) and 68% (Northern Europe) of women aged ≥65 years with a history of spine or hip fracture since age 45 were untreated. Among women with osteoporosis, the percentage of treated cases was lowest in Europe (45-52% versus 62-65% elsewhere). Women with osteopenia and no other risk factors were treated with anti-osteoporosis medication most frequently in U.S.A. (31%) and Canada (31%), and least frequently in Southern Europe (12%), Northern Europe (13%), and Australia (16%). After adjusting for risk factors, U.S. women were threefold as likely to be treated with anti-osteoporosis medication as Northern European women (odds ratio 2.8; 95% confidence interval 2.5-3.1) and 1.5 times as likely to be treated as Southern European women (1.5, 1.4-1.6). Up to half of women reporting previous hip or spine fracture did not receive treatment.
  
  
  CONCLUSIONS
  The likelihood of being treated for osteoporosis differed between regions, and cannot be explained by variation in risk factors. Many women at risk of fracture do not receive prophylaxis.
authors: Hospital del Mar-IMIM, Autonomous University of Barcelona and RETICEF, Instituto Carlos III, Barcelona, Spain. Adiez@hospitaldelmar.cat
authors: Adolfo
authors: A
authors: Díez-Pérez
authors: Frederick H
authors: FH
authors: Hooven
authors: Jonathan D
authors: JD
authors: Adachi
authors: Silvano
authors: S
authors: Adami
authors: Frederick A
authors: FA
authors: Anderson
authors: Steven
authors: S
authors: Boonen
authors: Roland
authors: R
authors: Chapurlat
authors: Juliet E
authors: JE
authors: Compston
authors: Cyrus
authors: C
authors: Cooper
authors: Pierre
authors: P
authors: Delmas
authors: Susan L
authors: SL
authors: Greenspan
authors: Andrea Z
authors: AZ
authors: Lacroix
authors: Robert
authors: R
authors: Lindsay
authors: J Coen
authors: JC
authors: Netelenbos
authors: Johannes
authors: J
authors: Pfeilschifter
authors: Christian
authors: C
authors: Roux
authors: Kenneth G
authors: KG
authors: Saag
authors: Philip
authors: P
authors: Sambrook
authors: Stuart
authors: S
authors: Silverman
authors: Ethel S
authors: ES
authors: Siris
authors: Nelson B
authors: NB
authors: Watts
authors: Grigor
authors: G
authors: Nika
authors: Stephen H
authors: SH
authors: Gehlbach
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