title: Use of pharmacologic agents for the primary prevention of osteoporosis among older women with low bone mass.
abstract: We examined the use of pharmacologic agents for the primary prevention of osteoporosis among older women with osteopenia. We found that these individuals were not managed in concordance with the National Osteoporosis Foundation (NOF) guidelines and that self-perceived osteoporosis risk and lower bone density were strongly associated with receipt of treatment.
  
  
  BACKGROUND
  Although osteoporosis medications are used for the primary prevention of osteoporosis among persons with low bone mass (osteopenia), their use may be discordant with clinical practice guidelines.
  
  
  METHODS
  We studied women 55 years and older participating in the Global Longitudinal Study of Osteoporosis in Women (GLOW). Eligible participants had a dual energy x-ray absorptiometry (DXA) test performed at the University of Alabama at Birmingham hospital and had an osteopenia diagnosis based on their DXA test results. Participants' demographics, fracture risk factors, and exposure to osteoporosis medications were determined from the GLOW survey. We examined the proportions of women managed in concordance with the National Osteoporosis Foundation 2008 guidelines, and we assessed factors independently associated with osteoporosis treatment decisions. Women with a prior spine or hip fracture were excluded.
  
  
  RESULTS
  Among 597 eligible women from GLOW, the mean age ± standard deviation (SD) was 70 ± 7 years. Among all subjects, 309 (52%) were treated in concordance with the NOF 2008 guidelines. Greater self-perceived osteoporosis risk and lower bone mineral density were significantly and consistently associated with receipt of osteoporosis treatment, both for those considered appropriate and for those considered inappropriate for treatment based on the NOF guidelines.
  
  
  CONCLUSIONS
  We found significant discordance between NOF 2008 guidelines and pharmacologic management of women with osteopenia. A person's self-perceived osteoporosis risk and bone mineral density were most strongly associated with receipt of osteoporosis medication use among women with low bone mass.
authors: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: J
authors: J
authors: Zhang
authors: E
authors: E
authors: Delzell
authors: J R
authors: JR
authors: Curtis
authors: F
authors: F
authors: Hooven
authors: S H
authors: SH
authors: Gehlbach
authors: F A
authors: FA
authors: Anderson
authors: K G
authors: KG
authors: Saag
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000407:Alabama; D001294:Attitude to Health; D015519:Bone Density / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000379:methods*; D012649:Self Concept
chemical_list: D050071:Bone Density Conservation Agents
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