TY - JOUR
T1 - Predicting osteoporosis medication receipt in Veterans with a spinal cord injury
T2 - A retrospective cohort study
AU - Weaver, Frances M.
AU - Le, Brian
AU - Ray, Cara
AU - Miskevics, Scott
AU - Gonzalez, Beverly
AU - Carbone, Laura D
N1 - Publisher Copyright:
© 2019, © The Academy of Spinal Cord Injury Professionals, Inc. 2019.
PY - 2019/11/2
Y1 - 2019/11/2
N2 - Objective: To describe frequency and predictors of use of pharmacological therapies for osteoporosis in persons with a spinal cord injury (SCI). Design: Retrospective cohort study. Setting: United States Veterans Health Administration (VA) national databases. Participants: 11,048 persons with a traumatic SCI who received VA health care between Fiscal Years (FY) 2005–2015. Pharmacy data from VA’s Corporate Data Warehouse were used to identify prescriptions for Food and Drug Administration-approved pharmacological treatments for osteoporosis including bisphosphonates, calcitonin, denosumab, raloxifene and teriparatide. Outcome Measures: Demographics, clinical and SCI-related characteristics, receipt of a dual energy x-ray absorptiometry (DXA), and prevalent lower extremity fractures were examined to determine factors related to receiving a pharmacological agent for osteoporosis. Results: 1,041 persons (9.4%) had a prescription for a pharmacological agent for osteoporosis; the majority (n = 964, 93.0%) were bisphosphonates. There was a significant decline in the number of these prescriptions from FY 2005 (13.0%) to FY 2015 (2.2%). In multivariable analysis, age (>50 years) (OR = 1.60, 95% CI 1.31–1.94); female sex (OR = 4.09, 95% CI 2.74–6.09); opioid (OR = 1.24, 95% CI 1.01–1.51) or corticosteroid (OR = 1.92, 95% CI 1.01–1.51) prescriptions; complete injury (OR = 1.26, 95% CI 1.04–1.53); receipt of a DXA scan (OR = 84.03, 95% CI 59.80–118.07) and prevalent fracture (OR = 5.43, 95% CI 4.13–7.15) were positive predictors. Black race (OR = 0.43, 95% CI 0.33–0.57) and obese BMI (OR = 0.59, 95% CI 0.45–0.76) were negative predictors. Conclusions: Prescriptions for osteoporosis medications for persons with a SCI declined in recent years. The strongest predictors for having filled these prescriptions were having had a DXA or a prevalent fracture.
AB - Objective: To describe frequency and predictors of use of pharmacological therapies for osteoporosis in persons with a spinal cord injury (SCI). Design: Retrospective cohort study. Setting: United States Veterans Health Administration (VA) national databases. Participants: 11,048 persons with a traumatic SCI who received VA health care between Fiscal Years (FY) 2005–2015. Pharmacy data from VA’s Corporate Data Warehouse were used to identify prescriptions for Food and Drug Administration-approved pharmacological treatments for osteoporosis including bisphosphonates, calcitonin, denosumab, raloxifene and teriparatide. Outcome Measures: Demographics, clinical and SCI-related characteristics, receipt of a dual energy x-ray absorptiometry (DXA), and prevalent lower extremity fractures were examined to determine factors related to receiving a pharmacological agent for osteoporosis. Results: 1,041 persons (9.4%) had a prescription for a pharmacological agent for osteoporosis; the majority (n = 964, 93.0%) were bisphosphonates. There was a significant decline in the number of these prescriptions from FY 2005 (13.0%) to FY 2015 (2.2%). In multivariable analysis, age (>50 years) (OR = 1.60, 95% CI 1.31–1.94); female sex (OR = 4.09, 95% CI 2.74–6.09); opioid (OR = 1.24, 95% CI 1.01–1.51) or corticosteroid (OR = 1.92, 95% CI 1.01–1.51) prescriptions; complete injury (OR = 1.26, 95% CI 1.04–1.53); receipt of a DXA scan (OR = 84.03, 95% CI 59.80–118.07) and prevalent fracture (OR = 5.43, 95% CI 4.13–7.15) were positive predictors. Black race (OR = 0.43, 95% CI 0.33–0.57) and obese BMI (OR = 0.59, 95% CI 0.45–0.76) were negative predictors. Conclusions: Prescriptions for osteoporosis medications for persons with a SCI declined in recent years. The strongest predictors for having filled these prescriptions were having had a DXA or a prevalent fracture.
KW - Osteoporosis
KW - Spinal cord injury
UR - http://www.scopus.com/inward/record.url?scp=85063203060&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063203060&partnerID=8YFLogxK
U2 - 10.1080/10790268.2019.1584259
DO - 10.1080/10790268.2019.1584259
M3 - Article
C2 - 30888309
AN - SCOPUS:85063203060
SN - 1079-0268
VL - 42
SP - 760
EP - 767
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
IS - 6
ER -