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Health Services Research & Development

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2008 HSR&D National Meeting Abstract

National Meeting 2008

1017 — Recognition and Treatment of Male Osteoporosis Is Low in at Least One VISN

LaFleur J (Salt Lake City IDEAS Center), Pickard SG (Salt Lake City IDEAS Center), Nebeker JR (Salt Lake City IDEAS Center)

The prevalence of osteoporosis among males over age 50 in the US ranges from 3% of Hispanics and 4% of Blacks to 7% of White and Asian men. The expected rate of fragility fractures for males over age 50 is 25% in their remaining lifetimes. In secondary osteoporosis, bisphosphonates have been shown to reduce the risk of these fractures by 67-81%. The purpose of this analysis was to characterize the disease burden of osteoporosis and fragility fractures among male veterans in one VISN and proportions treated with bisphosphonates.

We used the clinical data warehouse of VISN 19 to create a cohort of male veterans over the age of 49 who received care during the calendar years of 2005 and 2006. We identified the proportion with a diagnosis of osteoporosis, the proportion with a history of non-traumatic fragility fracture, and the proportion that were prescribed an oral bisphosphonate (alendronate, ibandronate, or risedronate).

129,476 males age 50 and over received care. The mean age of the cohort was 67.6 (SD 10.6). Among the 49% with recorded race information, 92% were Caucasian. An osteoporosis diagnosis was reported in only 1.9% of patients (n=2,401). The prevalence of those with a fragility fracture during the two-year period was 1.3% (n=1,691). Among those that had a fragility fracture, only 6.3% (n=106) had a prescription for an oral bisphosphonate. Further analysis on risk adjusted incidence and on treatment following new fractures will be presented over a longer period of follow up.

In one VISN, the proportion of men diagnosed with osteoporosis is less than a third of the national rate. Moreover, only a small fraction of veterans with fragility fractures appear to be receiving oral bisphosphonates, the current standard of care for men.

Osteoporosis is an under-recognized threat to male veterans in at least one VISN. Interventions should be explored to increase the diagnosis and adequate treatment of osteoporosis in the Veterans Health Administration.

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