title: Educational level and use of osteoporosis drugs in elderly men and women: a Swedish nationwide register-based study.
abstract: CONCLUSIONS
  We examined educational disparities in use of osteoporosis drugs in a nationwide population of Swedes aged 75-89 years old. Individuals with high education were more likely to receive osteoporosis drug treatment than lower educated individuals, particularly among women.
  
  
  BACKGROUND
  This study aims to investigate whether educational level is associated with use of osteoporosis drugs in the general population of older men and women in Sweden, also after adjustment for fractures.
  
  
  METHODS
  By record linkage of The Swedish Prescribed Drug Register, The Swedish Patient Register, and The Swedish Education Register, we obtained information on filling of prescriptions for osteoporosis drugs (bisphosphonates, calcium/vitamin D combinations, and selective estrogen receptor modulators) from July to October 2005, osteoporotic fractures from 1998 to 2004, and educational level for 645,429 people aged 75-89 years. Multivariate logistic regression analysis was used to investigate whether education was associated with use of osteoporosis drug therapy.
  
  
  RESULTS
  Higher education was associated with use of osteoporosis drugs for both men [odds ratio (OR)(high education vs low), 1.27; 95% confidence interval (CI), 1.19-1.35] and women (OR(high education vs low), 1.57; 95% CI, 1.52-1.61), after adjustment for age, osteoporotic fractures, and comorbidity (i.e., number of other drugs). Among those who had sustained a fracture (n = 57,613), the educational differences in osteoporosis drug treatment were more pronounced in women than men. Further, women were more likely to receive osteoporosis drug treatment after osteoporotic fracture.
  
  
  CONCLUSIONS
  Uptake of osteoporosis drug therapy seems to be unequally distributed in the elderly population, even in a country with presumably equal access to health care.
authors.affiliation: Aging Research Center, Karolinska Institutet & Stockholm University, Gävlegatan 16, S-113 30, Stockholm, Sweden. Jonas.wastesson@ki.se
authors.forename: J W
authors.initials: JW
authors.lastname: Wastesson
authors.forename: G
authors.initials: G
authors.lastname: Ringbäck Weitoft
authors.forename: M G
authors.initials: MG
authors.lastname: Parker
authors.forename: K
authors.initials: K
authors.lastname: Johnell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy* / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000517:prevention & control; D012042:Registries; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D050071:Bone Density Conservation Agents