ArticleAge and ageing2021
Factors associated with initiation of bone-health medication among older adults in primary care in Ireland.
Article in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 12 citations in OpenAlex.
- Osteoporosis Treatment Gap - A Systematic Literature Review.Zdravstveno varstvo · 2026Review
- Osteoporosis treatment gap and prescribing patterns in Ireland: a cross-sectional analysis of the DXA HIP project.BMJ open · 2026Article
- Post-fracture care and predictors of anti-osteoporotic treatment in Switzerland: a nationwide health claims analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- The estimated prevalence of osteoporosis in Bahrain: a multi-centered-based study.BMC musculoskeletal disorders · 2024Article
- Development of a Frailty Index in the Irish Hip Fracture Database.Archives of orthopaedic and trauma surgery · 2023Article
- Fragility fracture care gap at a tertiary teaching hospital in Malaysia.Archives of osteoporosis · 2023Article
- Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX.Archives of osteoporosis · 2023Article
- Two-country comparison of the prescription of bone protection medication before and early after hip fracture.Archives of osteoporosis · 2022Article
- Fracture liaison services in Ireland-how do we compare to international standards?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Article
- Persistence with oral bisphosphonates and denosumab among older adults in primary care in Ireland.Archives of osteoporosis · 2021Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdults at high risk of fragility fracture should be offered pharmacological treatment when not contraindicated, however, under-treatment is common.
objectiveThis study aimed to investigate factors associated with bone-health medication initiation in older patients attending primary care.
designThis was a retrospective cohort study.
settingThe study used data from forty-four general practices in Ireland from 2011-2017. SUBJECTS: The study included adults aged ≥ 65 years who were naïve to bone-health medication for 12 months.
methodsOverall fracture-risk (based on QFracture) and individual fracture-risk factors were described for patients initiated and not initiated onto medication and compared using generalised linear model regression with the Poisson distribution.
resultsOf 36,799 patients (51% female, mean age 75.4 (SD = 8.4)) included, 8% (n = 2,992) were observed to initiate bone-health medication during the study. One-fifth of all patients (n = 8,193) had osteoporosis or had high fracture-risk but only 21% of them (n = 1,687) initiated on medication. Female sex, older age, state-funded health cover and osteoporosis were associated with initiation. Independently of osteoporosis and co-variates, high 5-year QFracture risk for hip (IRR = 1.33 (95% CI = 1.17-1.50), P < 0.01) and all fractures (IRR = 1.30 (95% CI = 1.17-1.44), P < 0.01) were associated with medication initiation. Previous fracture, rheumatoid arthritis and corticosteroid use were associated with initiation, while liver, kidney, cardiovascular disease, diabetes and oestrogen-only hormone replacement therapy showed an inverse association.
conclusionsBone-health medication initiation is targeted at patients at higher fracture-risk but much potential under-treatment remains, particularly in those >80 years and with co-morbidities. This may reflect clinical uncertainty in older multimorbid patients, and further research should explore decision-making in preventive bone medication prescribing.
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