Primary-care prescribing of anti-osteoporotic-type medications following hospitalisation for fractures.

Abstract

We examined the prescribing of antiosteoporotic medications pre- and post hospital admission in patients with fragility fractures as well as factors associated with prescribing of these treatments following admission.

We identified all patients aged ≥ 55 years at a large teaching hospital between 2005 and 2008 with a fracture using the Hospital In-Patient Enquiry (HIPE) system. These data were linked to prescribing data from the Health Service Executive Primary Care Reimbursement Services (HSE-PCRS) scheme before and after discharge (821 patients). Logistic regression analysis was used to examine the likelihood of prescription of antiosteoporotic medication pre- and post discharge in relation to year of discharge, age, gender, and type of fracture.

Prescribing of antiosteoporotic treatment before fracture increased from 2.6% [95% confidence interval (CI) 2.23-2.93%] in 2005 to 10.6% (95% CI 9.32-11.86) by 2008, whereas post fracture prescribing increased from 11% (95% CI 9.64-12.36) to 47% (95% CI 43.6-50.3). In patients discharged from hospital in 2007, postfracture prescribing was 31.8% (95% CI 28.66-35.02) at 12 months, increasing to 50.3% (95% CI 46.6-53.9) at 24 months. The highest rate of prescribing was in the 65- to 69-year age group [odds ratio (OR) 8.51, 95% CI 1.75-41.35]. Patients discharged in 2008 were eight times more likely to be treated than patients discharged in 2005 (OR 8.01, 95% CI 4.55-14.09).

The percentage of patients on antiosteoporotic treatment post fracture increased significantly from 2005 to 2008. This may be largely due to the introduction of the Osteoporosis Clinic to the hospital in 2005.