Assistant Professor Touro College of Pharmacy New York, United States
Background: Research has shown that use of evidence-based osteoporosis treatment can prevent up to 32% of bone fractures. However, osteoporosis has long been seen as a women’s disease due to the huge difference in the recorded prevalence of osteoporosis between men and women, and men and their physicians tend to lack awareness of osteoporosis and underutilize evidence-based osteoporosis treatment.
Objectives: To assess the impact of awareness of osteoporosis on osteoporosis medication use among elderly men and women with osteoporosis.
Methods: A pooled cross-sectional study of Medicare beneficiaries aged 65 years and older with evidence of osteoporosis (from claims or self-report) living in the community using 2016-2018 Medicare Current Beneficiary Survey (MCBS) data linked with Medicare claims. Prescription medications used to treat osteoporosis included bisphosphonate, calcitonin, parathyroid hormone analog, selective estrogen receptor modulator, and RANKL inhibitor. Awareness of osteoporosis and bone mineral density (BMD) testing was captured in survey responses. Descriptive analyses on the characteristics of the sample and awareness of osteoporosis and BMD testing using chi-square test for categorical variables and then two multivariable logistic regressions with full sample weights and replicate weights using the balanced repeated replication method for variance estimation to estimate the impact of awareness of osteoporosis and BMD testing on osteoporosis medication use in men and women while adjusting for the covariates were conducted. Covariates included demographic characteristics, socioeconomic status, Medicare supplemental insurance, self-reported health status, conditions, diseases, and medications contributing to osteoporosis and/or bone fractures, risk factors for fall, limitations of daily activities, and receipt of other preventative services covered by Medicare identified in the self-report.
Results: The study sample comprised 866 male and 6,379 female Medicare beneficiaries with evidence of osteoporosis. Prevalence of osteoporosis medication use in men was substantially lower than that for women. In multivariable logistic regressions, women with awareness of osteoporosis and BMD testing were more likely to use any osteoporosis medications (OR=1.49, p=0.196 and OR=1.24, p=0.356, respectively) while adjusting for the covariates whereas no significant association between awareness of osteoporosis and BMD testing and osteoporosis medication use was found in men.
Conclusions: Men are significantly undertreated for osteoporosis compared to women. However, awareness of osteoporosis and BMD testing was associated with more osteoporosis medication use only in women. Further research on larger samples is warranted.
