An Opportunity for Improving Osteoporosis Treatment in Home Health Care

Julie A Switzer, Sharon J. Rolnick, Jody M. Jackson, Nicole K. Schneider, Jeanne E. Dutkowski, Denise R. Edgett

Research output: Contribution to journalArticle

Abstract

Purpose: To examine osteoporosis prevention and treatment among home health care (HHC) patients at risk of fragility fracture in a large, Midwestern integrated HHC system. Methods: All patients who received HHC services in 2006 were identified. International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes and pharmaceutical data were examined between January 1, 2004 and December 31, 2005 to determine risk status (high vs average) for fragility fracture. Patients with a documented diagnosis of osteoporosis, osteopenia, previous fragility fracture, stroke, or those taking a glucocorticoid were categorized as high risk. Pharmaceutical data (eg, estrogen, bisphosphonates) were obtained during the same 2-year period to determine treatment status. Descriptive statistics documented the proportion at high risk and treatment status. Inferential statistics tested differences in characteristics (age, gender, race, number of comorbidities) among high-risk patients with and without treatment. Results: 2798 patients were seen in HHC during 2006 and had utilization data available in 2004 and 2005. Of these, 754 were categorized as high risk and 2044 as average risk. Approximately one third (34%) of high-risk patients received osteoporosis medication compared to 4% of average risk (P < .0001). We found no treatment differences based on age. Those with higher comorbidity profiles were less likely to receive treatment (P < .0001). Conclusion: Only 34% of HHC patients at high risk for fracture received adequate treatment. Patients with more comorbidities were least likely to receive treatment. Since these individuals are receiving medical and nursing care, an opportunity exists to increase treatment rates for those at greatest risk.

Original languageEnglish (US)
Pages (from-to)46-51
Number of pages6
JournalGeriatric Orthopaedic Surgery & Rehabilitation
Volume1
Issue number2
DOIs
StatePublished - Jan 1 2010

Fingerprint

Home Care Services
Osteoporosis
Delivery of Health Care
Therapeutics
Comorbidity
International Classification of Diseases
Integrated Delivery of Health Care
Metabolic Bone Diseases
Diphosphonates
Nursing Care
Pharmaceutical Preparations
Glucocorticoids
Health Services
Estrogens
Stroke

Keywords

  • Aged
  • bone density conservation agents
  • home care services
  • osteoporosis
  • risk factors

Cite this

An Opportunity for Improving Osteoporosis Treatment in Home Health Care. / Switzer, Julie A; Rolnick, Sharon J.; Jackson, Jody M.; Schneider, Nicole K.; Dutkowski, Jeanne E.; Edgett, Denise R.

In: Geriatric Orthopaedic Surgery & Rehabilitation, Vol. 1, No. 2, 01.01.2010, p. 46-51.

Research output: Contribution to journalArticle

Switzer, Julie A ; Rolnick, Sharon J. ; Jackson, Jody M. ; Schneider, Nicole K. ; Dutkowski, Jeanne E. ; Edgett, Denise R. / An Opportunity for Improving Osteoporosis Treatment in Home Health Care. In: Geriatric Orthopaedic Surgery & Rehabilitation. 2010 ; Vol. 1, No. 2. pp. 46-51.
@article{aef6ae4c9e444dab88cf1106cba9fb3d,
title = "An Opportunity for Improving Osteoporosis Treatment in Home Health Care",
abstract = "Purpose: To examine osteoporosis prevention and treatment among home health care (HHC) patients at risk of fragility fracture in a large, Midwestern integrated HHC system. Methods: All patients who received HHC services in 2006 were identified. International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes and pharmaceutical data were examined between January 1, 2004 and December 31, 2005 to determine risk status (high vs average) for fragility fracture. Patients with a documented diagnosis of osteoporosis, osteopenia, previous fragility fracture, stroke, or those taking a glucocorticoid were categorized as high risk. Pharmaceutical data (eg, estrogen, bisphosphonates) were obtained during the same 2-year period to determine treatment status. Descriptive statistics documented the proportion at high risk and treatment status. Inferential statistics tested differences in characteristics (age, gender, race, number of comorbidities) among high-risk patients with and without treatment. Results: 2798 patients were seen in HHC during 2006 and had utilization data available in 2004 and 2005. Of these, 754 were categorized as high risk and 2044 as average risk. Approximately one third (34{\%}) of high-risk patients received osteoporosis medication compared to 4{\%} of average risk (P < .0001). We found no treatment differences based on age. Those with higher comorbidity profiles were less likely to receive treatment (P < .0001). Conclusion: Only 34{\%} of HHC patients at high risk for fracture received adequate treatment. Patients with more comorbidities were least likely to receive treatment. Since these individuals are receiving medical and nursing care, an opportunity exists to increase treatment rates for those at greatest risk.",
keywords = "Aged, bone density conservation agents, home care services, osteoporosis, risk factors",
author = "Switzer, {Julie A} and Rolnick, {Sharon J.} and Jackson, {Jody M.} and Schneider, {Nicole K.} and Dutkowski, {Jeanne E.} and Edgett, {Denise R.}",
year = "2010",
month = "1",
day = "1",
doi = "10.1177/2151458510386950",
language = "English (US)",
volume = "1",
pages = "46--51",
journal = "Geriatric Orthopaedic Surgery and Rehabilitation",
issn = "2151-4585",
publisher = "SAGE Publications Inc.",
number = "2",

}

TY - JOUR

T1 - An Opportunity for Improving Osteoporosis Treatment in Home Health Care

AU - Switzer, Julie A

AU - Rolnick, Sharon J.

AU - Jackson, Jody M.

AU - Schneider, Nicole K.

AU - Dutkowski, Jeanne E.

AU - Edgett, Denise R.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - Purpose: To examine osteoporosis prevention and treatment among home health care (HHC) patients at risk of fragility fracture in a large, Midwestern integrated HHC system. Methods: All patients who received HHC services in 2006 were identified. International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes and pharmaceutical data were examined between January 1, 2004 and December 31, 2005 to determine risk status (high vs average) for fragility fracture. Patients with a documented diagnosis of osteoporosis, osteopenia, previous fragility fracture, stroke, or those taking a glucocorticoid were categorized as high risk. Pharmaceutical data (eg, estrogen, bisphosphonates) were obtained during the same 2-year period to determine treatment status. Descriptive statistics documented the proportion at high risk and treatment status. Inferential statistics tested differences in characteristics (age, gender, race, number of comorbidities) among high-risk patients with and without treatment. Results: 2798 patients were seen in HHC during 2006 and had utilization data available in 2004 and 2005. Of these, 754 were categorized as high risk and 2044 as average risk. Approximately one third (34%) of high-risk patients received osteoporosis medication compared to 4% of average risk (P < .0001). We found no treatment differences based on age. Those with higher comorbidity profiles were less likely to receive treatment (P < .0001). Conclusion: Only 34% of HHC patients at high risk for fracture received adequate treatment. Patients with more comorbidities were least likely to receive treatment. Since these individuals are receiving medical and nursing care, an opportunity exists to increase treatment rates for those at greatest risk.

AB - Purpose: To examine osteoporosis prevention and treatment among home health care (HHC) patients at risk of fragility fracture in a large, Midwestern integrated HHC system. Methods: All patients who received HHC services in 2006 were identified. International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes and pharmaceutical data were examined between January 1, 2004 and December 31, 2005 to determine risk status (high vs average) for fragility fracture. Patients with a documented diagnosis of osteoporosis, osteopenia, previous fragility fracture, stroke, or those taking a glucocorticoid were categorized as high risk. Pharmaceutical data (eg, estrogen, bisphosphonates) were obtained during the same 2-year period to determine treatment status. Descriptive statistics documented the proportion at high risk and treatment status. Inferential statistics tested differences in characteristics (age, gender, race, number of comorbidities) among high-risk patients with and without treatment. Results: 2798 patients were seen in HHC during 2006 and had utilization data available in 2004 and 2005. Of these, 754 were categorized as high risk and 2044 as average risk. Approximately one third (34%) of high-risk patients received osteoporosis medication compared to 4% of average risk (P < .0001). We found no treatment differences based on age. Those with higher comorbidity profiles were less likely to receive treatment (P < .0001). Conclusion: Only 34% of HHC patients at high risk for fracture received adequate treatment. Patients with more comorbidities were least likely to receive treatment. Since these individuals are receiving medical and nursing care, an opportunity exists to increase treatment rates for those at greatest risk.

KW - Aged

KW - bone density conservation agents

KW - home care services

KW - osteoporosis

KW - risk factors

UR - http://www.scopus.com/inward/record.url?scp=84993734202&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84993734202&partnerID=8YFLogxK

U2 - 10.1177/2151458510386950

DO - 10.1177/2151458510386950

M3 - Article

AN - SCOPUS:84993734202

VL - 1

SP - 46

EP - 51

JO - Geriatric Orthopaedic Surgery and Rehabilitation

JF - Geriatric Orthopaedic Surgery and Rehabilitation

SN - 2151-4585

IS - 2

ER -