Patients 80 + have similar medication initiation rates to those aged 50–79 in Ontario FLS

Abstract

Summary

Among individuals presenting to an Ontario FLS, we compared bone active medication initiation rates of patients 80 years and older with those 50–79 years old. After accounting for fracture risk status, there was no statistically significant difference in medication initiation rates between the two age groups

Introduction

A Fracture Liaison Service (FLS) offers post-fracture services to individuals over the age of 50 years and could potentially address age inequities in pharmacotherapy often observed for older adults. Among individuals presenting to an Ontario FLS and classified as being at high risk for future fracture, our objective was to compare bone active medication initiation rates of patients 80 years and older with those 50–79 years old.

Methods

In 39 FLS fracture clinics across Ontario, Canada, fracture prevention coordinators identified, assessed, and facilitated the referral of eligible patients for bone densitometry, fracture risk assessment, and implementation of pharmacotherapy in patients classified as high risk for future fracture. Variables assessed at baseline included age, sex, marital status, living location, fracture location, history of previous fracture, parent’s history of hip fracture, history of falls, and fracture risk status. At 6 months, bone active medication initiation was assessed in patients classified as high risk for future fracture. The Chi-square test of independence was used to compare medication initiation rates between patients 80 + and those 50–79 years old.

Results

Our sample size consisted of 808 patients aged 50–79 years and 346 aged 80 + years. After accounting for fracture risk status, there was no statistically significant difference in medication initiation rates of patients 50–79 and 80 + years old (76.9% versus 73.7%, p = 0.251).

Conclusion

A systematic approach to identifying patients at high risk for future fracture and tailoring treatment recommendations to these patients appeared to eliminate differences in treatment initiation rates based on older age.

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Data availability

Not applicable.

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Funding

This study was supported by funding from the Ontario Ministry of Health and Long-Term Care (MOHLTC) through the Ontario Osteoporosis Strategy. The views expressed are those of the researchers and do not necessarily reflect those of the MOHLTC.

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Correspondence to J. E. M. Sale.

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The authors JEMS, AY, VE-G, RJ, RS, DL, JW, LF, and EB declare that they have no conflict of interest. EB has an unrestricted research grant from Amgen Canada and serves on an advisory board for Amgen Canada.

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The use of de-identified data for research purposes was approved by the research ethics board (REB#08-304) at St. Michael’s Hospital, Unity Health Toronto.

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Sale, J.E.M., Yang, A., Elliot-Gibson, V. et al. Patients 80 + have similar medication initiation rates to those aged 50–79 in Ontario FLS. Osteoporos Int (2021). https://doi.org/10.1007/s00198-020-05796-0

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Keywords

  • Fracture liaison service
  • Fracture risk
  • Fragility fracture
  • Medication initiation