Osteoporosis: risk factor prevalence and drug and densitometry utilization

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Abstract
Objective: To evaluate the prevalence of selected risk factors for postmenopausal osteoporosis, use of bone protective medications, and utilization of bone densitometry (DXA). Methods: Computerized records on demographics, medications dispensed, diagnostic/procedure summary lists, and radiology files for 33,662 women more than age 50 years who were current members of a health maintenance organization were merged and analyzed. Results: Overall, 4,733 (14%) women had recently been dispensed one or more bone protective medications: estrogens conjugated, 4,625 (13.7%); all other estrogens, 578 (2%); alendronate, 240 (1%); calcitonin, 499 (1%); etidronate disodium, 58 (1%); raloxifene, 82 (<1%); tamoxifen, 445 (1%). There were 14,668 (44%) who had one or more selected risk factors: current cigarette smoking, 7,607 (23%); weight less than 125 lb, 3,522 (11%); high-dose steroid use, 81 (<1%); on thyroid replacement, 3,227 (9.6%); chronic renal failure, 221 (1%); vertebral fractures, 208 (<1%); fracture of pelvis, 88 (<1%); femoral neck fractures, 240 (1%); on antiseizure medication, 177 (<1%); and on benzodiazepam or lithium, 1,145 (3%). Bone protective drug use was 17% in those with risk factors and 13% in those with none. Prior DXA was performed in 2.0% of those with risk factors and in 1% of those without risk factors. Conclusions: In this population (probably not unlike other populations), despite high prevalence of osteoporosis risk factors, DXA screening utilization is low (<2%), as is use of bone protective medications (14%).

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