Secondary prevention of osteoporosis in Australia: Analysis of government-dispensed prescription data

Hollingworth, Samantha A., Gunanti, Inong, Nissen, Lisa M. and Duncan, Emma L. (2010) Secondary prevention of osteoporosis in Australia: Analysis of government-dispensed prescription data. Drugs & Aging, 27 3: 255-264. doi:10.2165/11318400-000000000-00000


Author Hollingworth, Samantha A.
Gunanti, Inong
Nissen, Lisa M.
Duncan, Emma L.
Title Secondary prevention of osteoporosis in Australia: Analysis of government-dispensed prescription data
Journal name Drugs & Aging   Check publisher's open access policy
ISSN 1170-229X
1179-1969
Publication date 2010-03-01
Sub-type Article (original research)
DOI 10.2165/11318400-000000000-00000
Volume 27
Issue 3
Start page 255
End page 264
Total pages 10
Editor David Williamson
Place of publication Auckland, N.Z.
Publisher Adis International
Language eng
Formatted abstract
Background: Osteoporosis is a common cause of disability and death in elderly men and women. Until 2007, Australian Government-subsidized use of oral bisphosphonates, raloxifene and calcitriol (1α,25-dihydroxycholecalciferol) was limited to secondary prevention (requiring x-ray evidence of previous low-trauma fracture). The cost to the Pharmaceutical Benefits Scheme was substantial (164 million Australian dollars in 2005/6).

Objective: To examine the dispensed prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products for the secondary prevention of osteoporosis (after previous low-trauma fracture) in the Australian population.

Methods: We analysed government data on prescriptions for oral bisphosphonates, raloxifene, calcitriol and two calcium products from 1995 to 2006, and by sex and age from 2002 to 2006. Prescription counts were converted to defined daily doses (DDD)/1000 population/day. This standardized drug utilization method used census population data, and adjusts for the effects of aging in the Australian population.

Results: Total bisphosphonate use increased 460% from 2.19 to 12.26 DDD/1000 population/day between June 2000 and June 2006. The proportion of total bisphosphonate use in June 2006 was 75.1% alendronate, 24.6% risedronate and 0.3% etidronate. Raloxifene use in June 2006 was 1.32 DDD/1000 population/day. The weekly forms of alendronate and risedronate, introduced in 2001 and 2003, respectively, were quickly adopted. Bisphosphonate use peaked at age 80–89 years in females and 85–94 years in males, with 3-fold higher use in females than in males.

Conclusions: Pharmaceutical intervention for osteoporosis in Australia is increasing with most use in the elderly, the population at greatest risk of fracture. However, fracture prevalence in this population is considerably higher than prescribing of effective anti-osteoporosis medications, representing a missed opportunity for the quality use of medicines.
© 2010 Adis Data Information BV. All rights reserved.
Keyword Minimal-trauma fractures
Elderly-women
Therapy
Trends
Risk
Care
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
School of Pharmacy Publications
UQ Diamantina Institute Publications
 
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Created: Sun, 18 Apr 2010, 10:05:45 EST