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BACKGROUND: Vertebral fractures are associated with a reduction in quality of life and are an important predictor of other non-spine fractures. Previous work has shown that up to 60% of patients with a vertebral fracture identified in primary care remain untreated. OBJECTIVE: To examine the prevalence of pharmaceutical treatment and predictors of treatment in a primary care setting. METHODS: Case-control study using the general practice research database (GPRD). All women aged 50 years and over with a first diagnosis of a vertebral fracture since 1990 were identified and matched with a control by age and practice. Appropriate use of a pharmaceutical agent was defined as a prescription occurring within 30 days of the diagnosis being recorded. RESULTS: We identified 2719 women with the same number of controls. Within 30 days of diagnosis 61% of women were prescribed treatment, compared with only 3% of the controls. Bisphosphonate was the single most important treatment prescribed. Predictors of any drug treatment included: year of fracture (most recent year increased the likelihood of treatment); age (younger patients were more likely to receive treatment); history of back pain; low body weight; history of steroid use. CONCLUSIONS: Treatment of diagnosed vertebral fractures is becoming more common. Treated patients tend to be younger but to have a higher prevalence of clinical risk factors than untreated patients. There remain significant numbers of patients who are not offered treatment.

Original publication

DOI

10.1136/ard.2003.013508

Type

Journal article

Journal

Annals of the rheumatic diseases

Publication Date

07/2004

Volume

63

Pages

853 - 856

Addresses

Department of Health Sciences, University of York, York YO10 5DD. djt6@york.ac.uk

Keywords

Humans, Low Back Pain, Spinal Fractures, Diphosphonates, Glucocorticoids, Case-Control Studies, Family Practice, Age Factors, Patient Selection, Time Factors, Aged, Middle Aged, Female