ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025
Contemporary pharmacological management of patients after hip fracture: a population-based cohort of over 120,000 patients in Spain.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Post-Fracture Care After COVID-19 Mobility Restrictions in Older Adults with Femoral Neck Fracture: A Retrospective Pre-Post Study.Healthcare (Basel, Switzerland) · 2026Article
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Abstract
Treatment with antiosteoporotics is recommended after a hip fracture to reduce the risk of a new fracture or death. In our study, we found a slight increase in treatment rates over time, but an important treatment gap in the contemporary secondary prevention of hip fracture is still present.
introductionThe pharmacological management of patients after hip fracture is likely to have changed due to the availability of denosumab during the last decade, but the extent of its use and potential improvement in treatment rates in routine clinical practice is largely unknown.
methodsWe constructed a population-based retrospective cohort of all patients aged 65 years + , discharged alive following hip fracture hospitalization (Jan 2008 to Dec 2021) in several regions of Spain, accounting for one third of the country's population. The proportion of patients prescribed any antiosteoporotic (AO) medication and specific classes in the first 90 days after discharge was evaluated. Temporal trends of treatment prescription per month were plotted. All analyses were performed also by age, sex, and region.
resultsIn a cohort of over 120,000 patients, we found an important treatment gap in the secondary prevention of hip fracture (78% of patients untreated). Bisphosphonates and denosumab accounted for 60% and 20% of the AO prescriptions, respectively. Treatment gaps were most pronounced among patients aged 85 and over, and males: 26% of patients aged ≤ 84 were treated, in contrast to 18% of those aged 85 + . The proportion of females treated nearly doubled that of males (24% vs 14%). Differences by region were observed. Regarding time trends, despite finding an increase over time, prescription rates remained highly suboptimal. By drug class, treatment with bisphosphonates dropped, whereas denosumab treatment rose along the study period. Concerning management by sex, the Mediterranean regions showed a persistent gap over time, whereas in the Northern regions, the gap was gradually reduced. Treatment patterns by age groups were consistent over time.
conclusionsOur study offers evidence to identify current gaps of care in secondary prevention of hip fracture and implement adequate strategies to reduce recurrent fractures in this frail population.
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