Predicting osteoporosis medication receipt in Veterans with a spinal cord injury: A retrospective cohort study.
J Spinal Cord Med
; 42(6): 760-767, 2019 11.
Article
in En
| MEDLINE
| ID: mdl-30888309
ABSTRACT
Objective:
To describe frequency and predictors of use of pharmacological therapies for osteoporosis in persons with a spinal cord injury (SCI).Design:
Retrospective cohort study.Setting:
United States Veterans Health Administration (VA) national databases.Participants:
11,048 persons with a traumatic SCI who received VA health care between Fiscal Years (FY) 2005-2015. Pharmacy data from VA's Corporate Data Warehouse were used to identify prescriptions for Food and Drug Administration-approved pharmacological treatments for osteoporosis including bisphosphonates, calcitonin, denosumab, raloxifene and teriparatide.OutcomeMeasures:
Demographics, clinical and SCI-related characteristics, receipt of a dual energy x-ray absorptiometry (DXA), and prevalent lower extremity fractures were examined to determine factors related to receiving a pharmacological agent for osteoporosis.Results:
1,041 persons (9.4%) had a prescription for a pharmacological agent for osteoporosis; the majority (n = 964, 93.0%) were bisphosphonates. There was a significant decline in the number of these prescriptions from FY 2005 (13.0%) to FY 2015 (2.2%). In multivariable analysis, age (>50 years) (OR = 1.60, 95% CI 1.31-1.94); female sex (OR = 4.09, 95% CI 2.74-6.09); opioid (OR = 1.24, 95% CI 1.01-1.51) or corticosteroid (OR = 1.92, 95% CI 1.01-1.51) prescriptions; complete injury (OR = 1.26, 95% CI 1.04-1.53); receipt of a DXA scan (OR = 84.03, 95% CI 59.80-118.07) and prevalent fracture (OR = 5.43, 95% CI 4.13-7.15) were positive predictors. Black race (OR = 0.43, 95% CI 0.33-0.57) and obese BMI (OR = 0.59, 95% CI 0.45-0.76) were negative predictors.Conclusions:
Prescriptions for osteoporosis medications for persons with a SCI declined in recent years. The strongest predictors for having filled these prescriptions were having had a DXA or a prevalent fracture.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Osteoporosis
/
Drug Prescriptions
/
Spinal Cord Injuries
/
Veterans
/
Bone Density Conservation Agents
/
Osteoporotic Fractures
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
J Spinal Cord Med
Journal subject:
NEUROLOGIA
/
REABILITACAO
Year:
2019
Document type:
Article
Affiliation country: