Predicting osteoporosis medication receipt in Veterans with a spinal cord injury: A retrospective cohort study

Frances M. Weaver, Brian Le, Cara Ray, Scott Miskevics, Beverly Gonzalez, Laura D Carbone

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)760-767
Number of pages8
JournalJournal of Spinal Cord Medicine
Volume42
Issue number6
DOIs
StatePublished - Nov 2 2019

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Veterans
Spinal Cord Injuries
Osteoporosis
Prescriptions
Cohort Studies
Retrospective Studies
Pharmacology
Veterans Health
United States Department of Veterans Affairs
Diphosphonates
X-Rays
Teriparatide
Prescription Drugs
Calcitonin
United States Food and Drug Administration
Opioid Analgesics
Lower Extremity
Adrenal Cortex Hormones
Demography
Outcome Assessment (Health Care)

Keywords

  • Osteoporosis
  • Spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Predicting osteoporosis medication receipt in Veterans with a spinal cord injury : A retrospective cohort study. / Weaver, Frances M.; Le, Brian; Ray, Cara; Miskevics, Scott; Gonzalez, Beverly; Carbone, Laura D.

In: Journal of Spinal Cord Medicine, Vol. 42, No. 6, 02.11.2019, p. 760-767.

Research output: Contribution to journalArticle

Weaver, Frances M. ; Le, Brian ; Ray, Cara ; Miskevics, Scott ; Gonzalez, Beverly ; Carbone, Laura D. / Predicting osteoporosis medication receipt in Veterans with a spinal cord injury : A retrospective cohort study. In: Journal of Spinal Cord Medicine. 2019 ; Vol. 42, No. 6. pp. 760-767.
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abstract = "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.",
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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

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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.

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