Men aged at least 70 years receive less treatment for osteoporosis than women of the same age, according to findings published in the Journal of Pharmaceutical Health Services Research. In addition, black adults are undertreated for osteoporosis compared with other populations.
Feng‐Hua Ellen Loh
“Osteoporosis is an asymptomatic disease and has long been seen as a women’s disease; therefore, men may not be aware of osteoporosis and its related bone fractures and thus do not pursue care,” Feng‐Hua Ellen Loh, PhD, BPharm, assistant professor in the department of social, behavioral and administrative sciences at Touro College of Pharmacy in New York, told Endocrine Today. “However, men diagnosed with osteoporosis have a higher risk of bone fracture compared to women and suffer more sever outcomes after having a bone fracture. Therefore, it is crucial to improve osteoporosis care in men.”
Using Medicare data from the Chronic Condition Data Warehouse, Loh and colleagues conducted a study investigating sex-based differences in osteoporosis treatment between 2006 and 2008. All study participants (n = 99,421; 91.4% women), which encompassed a 5% national random sample, were aged at least 70 years and diagnosed with osteoporosis before 2006. Participants were considered to be using osteoporosis medication if they had at least one prescription refill in a given year. Osteoporosis management was determined by the presence of bone mineral density testing.
More women in the cohort had osteoporosis than men (44% vs. 11%). Treatment rates were higher for women, with a range of 44.3% in 2006 to 42% in 2008 vs. a range of 25.2% and 24.5% for men in the same period, the researchers reported. Osteoporosis medication was less likely to be given to men when compared with women (RR = 0.2; 95% CI, 0.19-0.22). Nonbisphosphonates were more likely to be the medication choice for men who were treated (RR = 1.16; 95% CI, 1.16-1.17) compared with women who were treated.
Osteoporosis treatment was less likely for black men compared with white men (RR = 0.76; 95% CI, 0.68-0.85) and black women compared with white women (RR = 0.61; 95% CI, 0.59-0.63), according to the study. In addition, Hispanic women were less likely to be treated for osteoporosis compared with white women (RR = 1.36; 95% CI, 1.32-1.41).
“Such wide racial and ethnic differences raise important questions about osteoporosis education and access to care that deserve further research,” the researchers wrote.
The researchers also found a positive association between living in a nursing home and treatment probability in men (RR = 1.65; 95% CI, 1.44-1.9) and women (RR = 1.17; 95% CI, 1.15-1.2).
“Even though we already knew that elderly men were less likely to be treated for osteoporosis compared to elderly women from the literature, we were still surprised by the magnitude of the difference in treatment use,” Loh said. “The clinical implication of this study is that elderly men and their physicians should pay more attention to osteoporosis and manage it more appropriately.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.