Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage
Ethel S Siris,1 Jingbo Yu,2 Katalin Bognar,3 Mitch DeKoven,4 Anshu Shrestha,3 John A Romley,5 Ankita Modi2 1Toni Stabile Osteoporosis Center, Columbia University Medical Center, NY Presbyterian Hospital, New York, NY, 2Merck & Co., Inc., Kenilworth, NJ, 3Precision Health Economics, Los Ange...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2015-11-01
|
| Series: | Clinical Interventions in Aging |
| Subjects: | |
| Online Access: | https://www.dovepress.com/undertreatment-of-osteoporosis-and-thenbsprole-of-gastrointestinal-eve-peer-reviewed-article-CIA |
| _version_ | 1818842540909002752 |
|---|---|
| author | Siris ES Yu J Bognar K DeKoven M Shrestha A Romley JA Modi A |
| author_facet | Siris ES Yu J Bognar K DeKoven M Shrestha A Romley JA Modi A |
| author_sort | Siris ES |
| collection | DOAJ |
| description | Ethel S Siris,1 Jingbo Yu,2 Katalin Bognar,3 Mitch DeKoven,4 Anshu Shrestha,3 John A Romley,5 Ankita Modi2 1Toni Stabile Osteoporosis Center, Columbia University Medical Center, NY Presbyterian Hospital, New York, NY, 2Merck & Co., Inc., Kenilworth, NJ, 3Precision Health Economics, Los Angeles, CA, 4Real-World Evidence Solutions, IMS Health, Fairfax, VA, 5Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA Objectives: To examine the rate of osteoporosis (OP) undertreatment and the association between gastrointestinal (GI) events and OP treatment initiation among elderly osteoporotic women with Medicare Part D drug coverage.Methods: This retrospective cohort study utilized a 20% random sample of Medicare beneficiaries. Included were women ≥66 years old with Medicare Part D drug coverage, newly diagnosed with OP in 2007–2008 (first diagnosis date as the index date), and with no prior OP treatment. GI event was defined as a diagnosis or procedure for a GI condition between OP diagnosis and treatment initiation or at the end of a 12-month follow-up, whichever occurred first. OP treatment initiation was defined as the use of any bisphosphonate (BIS) or non-BIS within 1 year postindex. Logistic regression, adjusted for patient characteristics, was used to model the association between 1) GI events and OP treatment initiation (treated versus nontreated); and 2) GI events and type of initial therapy (BIS versus non-BIS) among treated patients only.Results: A total of 126,188 women met the inclusion criteria: 72.1% did not receive OP medication within 1 year of diagnosis and 27.9% had GI events. Patients with a GI event were 75.7% less likely to start OP treatment (odds ratio [OR]=0.243; P<0.001); among treated patients, patients with a GI event had 11.3% lower odds of starting with BIS versus non-BIS (OR=0.887; P<0.001).Conclusion: Among elderly women newly diagnosed with OP, only 28% initiated OP treatment. GI events were associated with a higher likelihood of not being treated and, among treated patients, a lower likelihood of being treated with BIS versus non-BIS. Keywords: gastrointestinal, osteoporosis, postmenopausal women, treatment initiation |
| first_indexed | 2024-12-19T04:43:36Z |
| format | Article |
| id | doaj.art-83f4592712ec42a1b6634728d88ef1d1 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-19T04:43:36Z |
| publishDate | 2015-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-83f4592712ec42a1b6634728d88ef1d12022-12-21T20:35:33ZengDove Medical PressClinical Interventions in Aging1178-19982015-11-01Volume 101813182424489Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverageSiris ESYu JBognar KDeKoven MShrestha ARomley JAModi AEthel S Siris,1 Jingbo Yu,2 Katalin Bognar,3 Mitch DeKoven,4 Anshu Shrestha,3 John A Romley,5 Ankita Modi2 1Toni Stabile Osteoporosis Center, Columbia University Medical Center, NY Presbyterian Hospital, New York, NY, 2Merck & Co., Inc., Kenilworth, NJ, 3Precision Health Economics, Los Angeles, CA, 4Real-World Evidence Solutions, IMS Health, Fairfax, VA, 5Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA Objectives: To examine the rate of osteoporosis (OP) undertreatment and the association between gastrointestinal (GI) events and OP treatment initiation among elderly osteoporotic women with Medicare Part D drug coverage.Methods: This retrospective cohort study utilized a 20% random sample of Medicare beneficiaries. Included were women ≥66 years old with Medicare Part D drug coverage, newly diagnosed with OP in 2007–2008 (first diagnosis date as the index date), and with no prior OP treatment. GI event was defined as a diagnosis or procedure for a GI condition between OP diagnosis and treatment initiation or at the end of a 12-month follow-up, whichever occurred first. OP treatment initiation was defined as the use of any bisphosphonate (BIS) or non-BIS within 1 year postindex. Logistic regression, adjusted for patient characteristics, was used to model the association between 1) GI events and OP treatment initiation (treated versus nontreated); and 2) GI events and type of initial therapy (BIS versus non-BIS) among treated patients only.Results: A total of 126,188 women met the inclusion criteria: 72.1% did not receive OP medication within 1 year of diagnosis and 27.9% had GI events. Patients with a GI event were 75.7% less likely to start OP treatment (odds ratio [OR]=0.243; P<0.001); among treated patients, patients with a GI event had 11.3% lower odds of starting with BIS versus non-BIS (OR=0.887; P<0.001).Conclusion: Among elderly women newly diagnosed with OP, only 28% initiated OP treatment. GI events were associated with a higher likelihood of not being treated and, among treated patients, a lower likelihood of being treated with BIS versus non-BIS. Keywords: gastrointestinal, osteoporosis, postmenopausal women, treatment initiation https://www.dovepress.com/undertreatment-of-osteoporosis-and-thenbsprole-of-gastrointestinal-eve-peer-reviewed-article-CIAOsteoporosisbisphosphonatesgastrointestinal disorderselderly womenundertreatment |
| spellingShingle | Siris ES Yu J Bognar K DeKoven M Shrestha A Romley JA Modi A Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage Clinical Interventions in Aging Osteoporosis bisphosphonates gastrointestinal disorders elderly women undertreatment |
| title | Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage |
| title_full | Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage |
| title_fullStr | Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage |
| title_full_unstemmed | Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage |
| title_short | Undertreatment of osteoporosis and the role of gastrointestinal events among elderly osteoporotic women with Medicare Part D drug coverage |
| title_sort | undertreatment of osteoporosis and the nbsp role of gastrointestinal events among elderly osteoporotic women with medicare part d drug nbsp coverage |
| topic | Osteoporosis bisphosphonates gastrointestinal disorders elderly women undertreatment |
| url | https://www.dovepress.com/undertreatment-of-osteoporosis-and-thenbsprole-of-gastrointestinal-eve-peer-reviewed-article-CIA |
| work_keys_str_mv | AT sirises undertreatmentofosteoporosisandthenbsproleofgastrointestinaleventsamongelderlyosteoporoticwomenwithmedicarepartddrugnbspcoverage AT yuj undertreatmentofosteoporosisandthenbsproleofgastrointestinaleventsamongelderlyosteoporoticwomenwithmedicarepartddrugnbspcoverage AT bognark undertreatmentofosteoporosisandthenbsproleofgastrointestinaleventsamongelderlyosteoporoticwomenwithmedicarepartddrugnbspcoverage AT dekovenm undertreatmentofosteoporosisandthenbsproleofgastrointestinaleventsamongelderlyosteoporoticwomenwithmedicarepartddrugnbspcoverage AT shresthaa undertreatmentofosteoporosisandthenbsproleofgastrointestinaleventsamongelderlyosteoporoticwomenwithmedicarepartddrugnbspcoverage AT romleyja undertreatmentofosteoporosisandthenbsproleofgastrointestinaleventsamongelderlyosteoporoticwomenwithmedicarepartddrugnbspcoverage AT modia undertreatmentofosteoporosisandthenbsproleofgastrointestinaleventsamongelderlyosteoporoticwomenwithmedicarepartddrugnbspcoverage |