Medical management patterns in a US commercial claims database following a nontraumatic fracture in postmenopausal women,Archives of Osteoporosis

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Medical management patterns in a US commercial claims database following a nontraumatic fracture in postmenopausal women
Archives of Osteoporosis ( IF 3.1 ) Pub Date : 2022-07-14 , DOI: 10.1007/s11657-022-01135-4
Xin Wang ₁ , Xiaoqing Xu ₂ , Mary Oates ₂ , Timothy Hill ₁ , Rolin L Wade ₁

Affiliation

Summary

Among women ≥ 50 years with fracture, 76% had not received osteoporosis diagnosis or treatment at 6 months and only 14% underwent a DXA scan. Nearly half of all and 90% of hip fracture patients required surgery. Fractures cause substantial clinical burden and are not linked to osteoporosis diagnosis or treatment.

Purpose

Osteoporosis (OP) and OP-related fractures are a major public health concern, associated with significant economic burden. This study describes management patterns following a nontraumatic fracture for commercially insured patients.

Methods

This retrospective cohort study identified women aged ≥ 50 years having their first nontraumatic index fracture (IF) between January 1, 2015 and June 30, 2019, from IQVIA’s PharMetrics® Plus claims database. Medical management patterns at month 6 and medication use patterns at months 6, 12, and 24 following the IF were described.

Results

Among 48,939 women (mean (SD) age: 62.7 (9.5) years), the most common fracture types were vertebral (30.6%), radius/ulna (24.9%), and hip (HF; 12.1%). By month 6, 76% of patients had not received an OP diagnosis or treatment, 13.6% underwent a DXA scan, and 11.2% received any OP treatment. Surgery was required in 43.1% of all patients and 90.0% of HF patients on or within 6 months of the fracture date. Among HF patients, 41.4% were admitted to a skilled nursing facility, 96.7% were hospitalized an average of 5.5 days, and 38.1% required durable medical equipment use. The 30-day all-cause readmission rate was 14.3% among those hospitalized for the IF. Overall, 7.4%, 9.9%, and 13.2% had a subsequent fracture at months 6, 12, and 24, respectively.

Conclusion

Our findings provide an overview of post-fracture management patterns using real-world data. OP was remarkably underdiagnosed and undertreated following the initial fracture. Nontraumatic fracture, particularly HF, resulted in substantial ongoing clinical burden.

中文翻译：

美国商业索赔数据库中绝经后妇女非创伤性骨折后的医疗管理模式

概括

在 50 岁以上的骨折女性中，76% 的女性在 6 个月时未接受过骨质疏松症诊断或治疗，只有 14% 的女性接受过 DXA 扫描。将近一半和 90% 的髋部骨折患者需要手术。骨折会造成巨大的临床负担，并且与骨质疏松症的诊断或治疗无关。

目的

骨质疏松症 (OP) 和 OP 相关骨折是一个主要的公共卫生问题，与重大的经济负担相关。本研究描述了商业保险患者非创伤性骨折后的管理模式。

方法

这项回顾性队列研究从 IQVIA 的 PharMetrics ® Plus 索赔数据库中确定了在 2015 年 1 月 1 日至 2019 年 6 月 30 日期间发生首次非创伤性指数骨折（ IF ）的年龄≥50 岁的女性。描述了 IF 后第 6 个月的医疗管理模式和第 6、12 和 24 个月的药物使用模式。

结果

在 48,939 名女性（平均 ( SD ) 年龄：62.7 (9.5) 岁）中，最常见的骨折类型是椎骨 (30.6%)、桡骨/尺骨 (24.9%) 和髋骨 (HF；12.1%)。到第 6 个月，76% 的患者未接受 OP 诊断或治疗，13.6% 接受了 DXA 扫描，11.2% 接受了任何 OP 治疗。43.1% 的所有患者和 90.0% 的 HF 患者在骨折日期或骨折日期后 6 个月内需要手术。在心衰患者中，41.4% 入住专业护理机构，96.7% 平均住院 5.5 天，38.1% 需要使用耐用的医疗设备。因 IF 住院的患者 30 天全因再入院率为 14.3%。总体而言，分别有 7.4%、9.9% 和 13.2% 的患者在第 6、12 和 24 个月发生了后续骨折。