Study Finds Lack of Osteoporosis Prevention in Older Women
A recent study examined fracture prevention among older women who were admitted to post-acute care facilities with new fractures. It was concluded that there was no osteoporosis risk management among these women before they were admitted or after they were discharged, reports McKnights.
The study included about 388,000 participants who were Medicare beneficiaries and had an incident fragility fracture. Study authors followed their healthcare resource utilization and related costs. The participants received care from either an inpatient rehabilitation facility, skilled nursing facility, long-term acute care hospital or home health care. Additionally, they also tracked the impact of the fracture on health-related quality of life or humanistic burden on residents of the skilled nursing facilities using linked Minimum Data Set assessments. The study began in January 2017 and ended on October 17, 2019.
In all settings, there was low usage of dual-energy x-ray absorptiometry (DXA) for screening of osteoporosis and medications to help prevent loss of bone. This was observed for both baseline and after discharge. During baseline, about 8 percent to 14 percent of patients received DXA and between 5 percent to 16 percent received them after post-acute discharge. Additionally, only about 10 to 12 percent of the patients were given osteoporosis medications during baseline.
According to E. Michael Lewiecki, MD, of the New Mexico Clinical Research and Osteoporosis Center in Albuquerque, NM, and colleagues, the total costs and hospitalization rates were high after post-acute care discharge from facilities when compared to the baseline.
Patients who had dual eligibility for Medicaid had 12 percent higher costs and Black patients had 14 percent higher costs. Visits to the emergency department were 1.3 times higher and hospitalization rates were 3.7 times higher. Costs were 2.7 times higher after patients were discharged from skilled nursing facilities when compared to the baseline.
Patients who stayed in skilled nursing facilities had an improvement of 3.5 points in activities of daily living scores. However, Black patients had 1.2 fewer points than white patients. There was no change in pain intensity scores at -0.8 points.
The authors concluded, “Our findings of underutilized medications and DXA scans highlight lack of clinical management of osteoporosis in women at risk for fracture. Results indicate a need for improved early diagnosis and aggressive disease management to prevent and treat fragility fractures.”
Read how bone fractures are associated with reduced life spans.
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