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4X increase in osteoporosis visits, but vitamin D information is still not available – May 2013

Curr Med Res Opin. 2013 May 29.
Rianon N, Anand D, Rasu R.
University of Texas Medical School at Houston, Houston TX USA.

Background: Inadequate treatment by non-specialty primary care physicians (PCPs) has been a concern in improving osteoporosis care. An increase in outpatient visits by older patients seeking osteoporosis care has been reported. But what percentages of these visits are made to PCPs are unknown. We investigated recent trends of outpatient visits and treatment for osteoporosis in older adults (> 50 years) by physician type (PCPs vs. specialty care non-PCPs). Methods: Cross-sectional analysis used National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2002-2008 in the USA. Patients ≥ 50years with osteoporosis were included. Descriptive and logistic analysis reported trends of visits and treatment for osteoporosis care by physician type.

Results: About 9 million weighted visits were reported from 2002-2008. An increase in osteoporosis related visits was noted from 5% in 2002 to 20% in 2008. Patients in majority of the visits were women (89%), between 65-84 years of age (56%), of non-Hispanic (88%) and White (81%) ethnic/racial backgrounds and had Medicare (51%) as source of payment. Almost half (49.5%) of the visits were made to the PCPs. About 74% visits recorded a prescription for osteoporosis treatment. Calcium supplementation was low in the study population, and lack of data on vitamin D supplements limit us in commenting on the supplementary aspect of osteoporosis management. Non-PCPs were more likely to have prescribed bisphosphonates (p<0.05) during an osteoporosis related visit compared to PCPs (Odds ratio:1.81,95% CI:1.12-2.92).

Conclusion: We report a change with increasing trends of out-patient visits to PCPs for osteoporosis care since the 1990s. Despite lower percentages of prescriptions by PCPs than non-PCPs, there is an increasing trend of prescribing osteoporosis treatment by PCPs. Growing demand for managing the chronic bone disease mandates a needs assessment for educational interventions to better prepare PCPs for improving skeletal health of the elderly.

PMID: 23718160

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