Pharmacological management, and potentially inappropriate prescriptions in patients with osteoporosis

ABSTRACT

Background

The treatment of osteoporosis involves medications that reduce the risk of fractures, but some medications can decrease bone density. The aim was to identify the treatments, comorbidities, and prescriptions related to reducing bone mineral density in patients with osteoporosis.

Research design and methods

A cross-sectional study that identified patterns of anti-osteoporotic drug prescriptions for outpatient use and potentially inappropriate prescriptions for patients with osteoporosis based on the drug-dispensing database of 8.5 million people in Colombia. All patients ≥65 years with a diagnosis of osteoporosis were included.  

Results

A total of 16,362 patients with osteoporosis were identified. They had a median age of 74.4 years, and 47.9% received anti-osteoporotic therapy, especially bisphosphonates (41.6%), and 86.5% received calcium and/or vitamin D supplement. 41.6% of those who had a history of bone fractures were prescribed anti-osteoporotic drugs. Potentially inappropriate prescriptions, especially corticosteroids at doses greater than 5mg prednisolone equivalent (4.4%), were found in 41.4% of cases and were more common in older patients and those with a history of fractures or with cardiovascular, digestive, neurological, psychiatric or neoplastic comorbidities.  

Conclusions

A significant proportion of patients had potentially inappropriate prescriptions, especially older patients, those with certain comorbidities, and those receiving comedication with antirheumatic drugs.

KEYWORDS:

• Glucocorticoids
• diphosphonates
• inappropriate prescribing
• fractures
• bone
• osteoporosis

Acknowledgments

The authors would like to thank Soffy Claritza López for for her work in obtaining the database.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Availability of data and material

protocols.io

Code availability

dx.doi.org/10.17504/protocols.io.bvizn4f6

Author contribution statement

LFV participated in the drafting, data collection, data analysis, description of results and discussion. KVD: methodology, formal analysis, investigation, data curation. NMPV: methodology, formal analysis, investigation, data curation. SJS: methodology, formal analysis, investigation, data curation JEMA participated in the drafting, data analysis, description of results, discussion, critical revision of the article, and evaluation of the final version of the manuscript.

Ethical approval

The protocol was approved by the Bioethics Committee of the Technological University of Pereira in the category of risk-free research (endorsement code: 03-191020). The ethical principles established by the Declaration of Helsinki were upheld. Approval date: October 22 of 2020.

Additional information

Funding

This paper was not funded.