title: Evaluation of fracture risk and potential drug holidays for postmenopausal women on long-term bisphosphonate therapy.
abstract: OBJECTIVE
  To describe characteristics of postmenopausal women on long-term bisphosphonate therapy who fall into one of four fracture risk categories (low, mild, moderate, high), and to determine the prevalence of women eligible for a drug holiday.
  
  
  METHODS
  Retrospective electronic health record review.
  
  
  METHODS
  Eight primary care clinics within a university-based health care system.
  
  
  METHODS
  A total of 201 postmenopausal women of ages 55-89 years, with osteopenia or osteoporosis, prescribed bisphosphonate therapy for >4 years, between October 10, 2002 and September 9, 2012.
  
  
  RESULTS
  The patients' mean age was 71.4 (±8.2) years; their mean body mass index was 25.3 (±5.6) kg/m(2); and 73.1% were white. Seventy-four out of 201 patients (36.8%) were low-risk; 10/201 (5.0%) were mild-risk; 72/201 (35.8%) were moderate-risk; and 45/201 (22.4%) were high-risk. Eighty-one women (40.3%) were eligible for a drug holiday or discontinuation. The estimated drug cost avoided per eligible patient was $574.80. Calcium and/or vitamin D supplementation was documented in 52.7% of women.
  
  
  CONCLUSIONS
  More than one-third of postmenopausal women taking long-term bisphosphonate therapy had low fracture risk, and over 40% of our patients were eligible for a drug holiday or discontinuation. These data emphasize the need to accurately assess risk and benefit in patients treated with bisphosphonate therapy.
authors.affiliation: Departments of Clinical Pharmacy and Family Medicine, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and School of Medicine, Aurora, CO, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Kostoff
authors.affiliation: Departments of Clinical Pharmacy and Family Medicine, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and School of Medicine, Aurora, CO, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Saseen
authors.affiliation: Departments of Clinical Pharmacy and Family Medicine, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and School of Medicine, Aurora, CO, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Borgelt
keywords: bisphosphonates; drug holiday; fracture; postmenopausal osteoporosis