Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study
Background: The characteristics of care home populations, with respect to fracture risk factors, have not been well-defined. Aim: To describe osteoporosis-related characteristics among care home residents, including fracture risk factors, fracture rates, post-fracture outcomes, and osteoporosis trea...
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Format: | Article |
Language: | English |
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Royal College of General Practitioners
2023-06-01
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Series: | BJGP Open |
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Online Access: | https://bjgpopen.org/content/7/2/BJGPO.2022.0142 |
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author | Vaiva Gerasimaviciute Rohini Mathur Kathryn Elizabeth Mansfield Matthew Paul McDermott David Edward Neasham James Liam O'Kelly |
author_facet | Vaiva Gerasimaviciute Rohini Mathur Kathryn Elizabeth Mansfield Matthew Paul McDermott David Edward Neasham James Liam O'Kelly |
author_sort | Vaiva Gerasimaviciute |
collection | DOAJ |
description | Background: The characteristics of care home populations, with respect to fracture risk factors, have not been well-defined. Aim: To describe osteoporosis-related characteristics among care home residents, including fracture risk factors, fracture rates, post-fracture outcomes, and osteoporosis treatment duration. Design & setting: A descriptive cohort study of care home residents aged ≥60 years (n = 8366) and a matched cohort of non-care home residents (n = 16 143) in England from 2012 to 2019. Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES) and Office for National Statistics (ONS) death data were used. Method: The characteristics were assessed using descriptive statistics. Fracture risk factors and fracture rates were described in both the care home and matched population. In the care home population, Kaplan–Meier curves were plotted to assess osteoporosis treatment duration. Results: At index, fracture risk factors were more common in care home residents versus the matched cohort, including body mass index (BMI) <18.5 (12.2% versus 5.1%), history of falls (48.9% versus 30.7%), prior fracture (26.5% versus 10.8%), and prior hip fracture (17.1% versus 5.8%). Fracture rate was 43.5 (95% confidence interval [CI] = 39.7 to 47.5) in care home residents and 28.0 (95% CI = 26.3 to 29.9) per 1000 person–years in the matched cohort. Overall, osteoporosis treatment was initiated in 3.6% (n = 225/6265) of care home residents and 45.9% remained on treatment at 12 months. Among care home residents who experienced fracture, 21.9% (n = 72/329) received an osteoporosis diagnosis; 21.2% (n = 63/297) initiated osteoporosis treatment post-hip fracture. Conclusion: Care home residents had more fracture risk factors and higher fracture rates than the matched cohort; however, osteoporosis diagnosis, treatment rates, and treatment duration were low. There is an opportunity to improve osteoporosis management in this vulnerable population. |
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id | doaj.art-d3acea912cc6432e9fa491561880d78b |
institution | Directory Open Access Journal |
issn | 2398-3795 |
language | English |
last_indexed | 2024-03-13T01:26:38Z |
publishDate | 2023-06-01 |
publisher | Royal College of General Practitioners |
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series | BJGP Open |
spelling | doaj.art-d3acea912cc6432e9fa491561880d78b2023-07-04T14:41:43ZengRoyal College of General PractitionersBJGP Open2398-37952023-06-017210.3399/BJGPO.2022.0142Osteoporosis-related characteristics in care home residents in England: a retrospective cohort studyVaiva Gerasimaviciute0Rohini Mathur1Kathryn Elizabeth Mansfield2Matthew Paul McDermott3David Edward Neasham4James Liam O'Kelly5Amgen Ltd, Uxbridge Business Park, Uxbridge, UKCenter for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UKLondon School of Hygiene and Tropical Medicine, London, UKAmgen Ltd, Uxbridge Business Park, Uxbridge, UKAmgen Ltd, Uxbridge Business Park, Uxbridge, UKAmgen Ltd, Uxbridge Business Park, Uxbridge, UKBackground: The characteristics of care home populations, with respect to fracture risk factors, have not been well-defined. Aim: To describe osteoporosis-related characteristics among care home residents, including fracture risk factors, fracture rates, post-fracture outcomes, and osteoporosis treatment duration. Design & setting: A descriptive cohort study of care home residents aged ≥60 years (n = 8366) and a matched cohort of non-care home residents (n = 16 143) in England from 2012 to 2019. Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES) and Office for National Statistics (ONS) death data were used. Method: The characteristics were assessed using descriptive statistics. Fracture risk factors and fracture rates were described in both the care home and matched population. In the care home population, Kaplan–Meier curves were plotted to assess osteoporosis treatment duration. Results: At index, fracture risk factors were more common in care home residents versus the matched cohort, including body mass index (BMI) <18.5 (12.2% versus 5.1%), history of falls (48.9% versus 30.7%), prior fracture (26.5% versus 10.8%), and prior hip fracture (17.1% versus 5.8%). Fracture rate was 43.5 (95% confidence interval [CI] = 39.7 to 47.5) in care home residents and 28.0 (95% CI = 26.3 to 29.9) per 1000 person–years in the matched cohort. Overall, osteoporosis treatment was initiated in 3.6% (n = 225/6265) of care home residents and 45.9% remained on treatment at 12 months. Among care home residents who experienced fracture, 21.9% (n = 72/329) received an osteoporosis diagnosis; 21.2% (n = 63/297) initiated osteoporosis treatment post-hip fracture. Conclusion: Care home residents had more fracture risk factors and higher fracture rates than the matched cohort; however, osteoporosis diagnosis, treatment rates, and treatment duration were low. There is an opportunity to improve osteoporosis management in this vulnerable population.https://bjgpopen.org/content/7/2/BJGPO.2022.0142homes for the agedosteoporotic fracturesgeneral practice |
spellingShingle | Vaiva Gerasimaviciute Rohini Mathur Kathryn Elizabeth Mansfield Matthew Paul McDermott David Edward Neasham James Liam O'Kelly Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study BJGP Open homes for the aged osteoporotic fractures general practice |
title | Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study |
title_full | Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study |
title_fullStr | Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study |
title_full_unstemmed | Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study |
title_short | Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study |
title_sort | osteoporosis related characteristics in care home residents in england a retrospective cohort study |
topic | homes for the aged osteoporotic fractures general practice |
url | https://bjgpopen.org/content/7/2/BJGPO.2022.0142 |
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