Factors Associated with Gaps in Osteoporosis Treatment—Factors

Adrianne C. Feldstein, Principal Investigator
Patricia J. Elmer, Mikel Aickin, David H. Smith, Co-Investigators

Funding source: Agency for Healthcare Research and Quality
Funding period: April 2002 – September 2003

The human and economic toll of osteoporotic fractures is staggering. Individuals who have had prior fractures are at increased risk of future fractures. Evidence-based clinical practice guidelines and effective treatment are readily available but incompletely utilized in this high-risk group. This retrospective cohort study is designed to evaluate the treatment gap in older women who have had a prior fracture associated with osteoporosis, to provide the foundation for designing future secondary prevention programs for re-fracture. The treatment gap, as defined for this study, is that a woman does not receive pharmacologic treatment for osteoporosis. The gap may be due to clinicians not following guidelines, or the gap may be due to the lack of patient compliance with recommended treatment. The primary aims are to determine, in women aged 50-89 years with a prior study-eligible clinical fracture, 1) the fraction of women with an osteoporosis treatment gap, and what fraction of the gap is due to clinicians not following the guidelines and what fraction is due to the lack of patient compliance; 2) the distribution of treatment duration and the distribution of patient compliance; and 3) which patient, health care provider, and health care benefit characteristics available in the Kaiser Permanente Northwest electronic databases are significantly associated with treatment gaps.

Kaiser Permanente