Happy old peopleA UK-wide study looking at the prescribing of anti-osteoporotic drugs (AOD) to people aged 50 years or above has found that, since 2006, AOD prescription rates for women have decreased and rates for men have levelled off, despite a growing elderly population and associated fracture risks.

The study follows on from a steep rise in prescribing rates since 1990. Additionally, there was marked geographic variation in prescribing rates, with greatest rates for men and women in Northern Ireland and the lowest rates for women in the East Midlands and men in Yorkshire and Humberside. 

The study, funded by the UK National Osteoporosis Society and Medical Research Council, used data from the UK Clinical Practice Research Datalink, a general practice based dataset including information on 7% of the UK population. 

The researchers analysed AOD prescriptions from 1990 to 2012, and found that far more women than men were prescribed AOD and that the rate of prescription increased with age, up to the age of 85-89 years, where women were more than twice as likely as men to be prescribed AODs. White and Asian women were twice as likely to be receiving AOD prescriptions as black women.

The study findings were unveiled in Rome today by Robert van der Velde, speaking at the 43rd annual congress of the European Calcified Tissue Society (ECTS). The study was carried out by Dr van der Velde, Consultant Endocrinologist at the Maastricht University Medical Centre and VieCuri Medical Centre, both in the Netherlands, with colleagues from the Netherlands and Belgium as well as from Southampton, Oxford and Manchester in the UK.

Dr van der Velde said: “The finding of geographic variation in anti-osteoporosis medication prescriptions is likely to reflect a range of factors, such as differences in age structure of the population, ethnic mix and socioeconomic status between the different regions of the UK. Further work will be required to investigate whether these differences also reflect variations in approaches to the prevention and treatment of osteoporosis, for example after hospital admission for a hip fracture.

“The decline in anti-osteoporosis medication prescriptions over the last 10 years is concerning, particularly in the context of an ever more elderly population, in which many fracture types are becoming more common. Other work from the CPRD has demonstrated an increase in rates of treatment for osteoporosis following a hip fracture, but still only just over half such patients receive treatment - there is a clear and urgent need for the field to close this care gap."

Professor Nicholas Harvey, Professor of Rheumatology and Clinical Epidemiology at the MRC Lifecourse Epidemiology Unit, University of Southampton, who oversaw the study, commented: "This work forms part of a larger series of studies, funded by the UK National Osteoporosis Society and Medical Research Council, in which we comprehensively assess the impact of fragility fractures in the UK. The current study, in combination with recent papers describing the burden of osteoporotic fracture in the UK population, gives really important information which will inform health planners not just in the UK, but in many other countries.”