Underdiagnosis, Undertreatment of Osteoporosis and Related Fractures High Among OAs

Researchers recently concluded that there is a higher level of underdiagnosis and undertreatment of osteoporosis and related fractures among older adults covered by Medicare.

“Due to an increasing aging population, the number of Americans at risk of fractures is projected to increase by 33% by 2030,” lead study author Jeffrey Curtis, MD, and colleagues explained. “Current data on burden of fractures in a population of Medicare enrollees will contribute to increased awareness among healthcare providers to facilitate appropriate care and access to therapy.”

In order to understand the baseline characteristics of older patients who experienced a fragility fracture, Dr Curtis and his colleagues included Medicare fee-for-service members with a closed fragility, or osteoporosis-related, fracture between January 1, 2010 and September 30, 2014 in their study. Patients included in the study were classified into four cohorts. The cohorts were determined based on the observed diagnosis and/or treatment of osteoporosis at baseline.

According to the researchers, of 18,936,386 beneficiaries, 885,676 met the study eligibility criteria. Additionally, the average age of the participants was 80.5 years, 90.9% were white, and 93.8% were female.

The findings of the study indicated that the most commonly observed fracture sites included spine, hope and radius or ulna.  At the baseline of the study, of the patients with a qualifying fracture, roughly 77% were neither diagnosed nor treated for osteoporosis. Further, 2.5% were diagnosed by not treated, 17.4% were treated but not diagnosed, and only 3.0% were diagnosed and treated. The researchers noted that roughly 87% of the observed patients had a comorbidity or were on a medication associated with an increased fall risk.

“The current study findings confirm a consistent high level of underdiagnosis and undertreatment of osteoporosis in Medicare population,” Dr Curtis and colleagues concluded. “Further documentation of cost of illness following an osteoporosis-related fracture, including identification of high cost drivers who may benefit from earlier targeted therapies, will be of value.”

This research was presented at the 2019 AMCP Annual Meeting.

—Julie Gould 

Reference:

Curtis J, Daigle S, Williams S, et al. Characterization of Medicare Patients with a Fragility Fracture [M17]. J Manag Care Spec Pharm. 2019;25(3-a). https://www.jmcp.org/doi/pdf/10.18553/jmcp.2019.25.3-a.s1