Undertreatment of osteoporosis in regional Western Australia.
OBJECTIVE
To identify the geographic differences in osteoporosis management.


METHODS
In this cross-sectional study, osteoporosis treatments in older patients presented to a hip fracture unit from mid 2005-2009 were analysed. Logistic regression was used to examine the association of rural residency with osteoporosis treatments.


RESULTS
Among 1130 patients (20% rural, mean age 81.1 years), there was a low prescription rate for osteoporosis among rural patients. Rural patients were 65% less likely to use vitamin D, 60% less likely to use calcium and 46% less likely to use bisphosphonates before a hip fracture than their urban counterparts. Their compliance with vitamin D and calcium was also lower at 1 year but improved significantly over the study period, whereas compliance with bisphosphonate decreased in both regions.


CONCLUSIONS
Undertreatment of osteoporosis was common in rural patients. These findings need to be confirmed by larger population-based studies.
Fracture Neck of Femur Unit, Royal Perth Hospital (Shenton Park Campus), Perth, Western Australia, Australia. michellemylai@gmail.com
Michelle Mei Yee
MM
Lai
Wan Mei
WM
Ang
Marjory
M
McGuiness
Amanda Barbara
AB
Larke
D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D004164:Diphosphonates / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D019983:Guideline Adherence; D006620:Hip Fractures / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016017:Odds Ratio; D010024:Osteoporosis / Q000188:drug therapy* / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013997:Time Factors; D014807:Vitamin D / Q000627:therapeutic use; D014904:Western Australia / Q000453:epidemiology
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium