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. 2022 Jul 14;17(1):92.
doi: 10.1007/s11657-022-01135-4.

Medical management patterns in a US commercial claims database following a nontraumatic fracture in postmenopausal women

Xin Wang  1 , Xiaoqing Xu  2 , Mary Oates  2 , Timothy Hill  3 , Rolin L Wade  3
Affiliations

Medical management patterns in a US commercial claims database following a nontraumatic fracture in postmenopausal women

Xin Wang et al. Arch Osteoporos. .

Abstract

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.

Keywords: Diagnosis; Fracture; Hospitalization; Osteoporosis; Surgery; Treatment.

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Conflict of interest statement

Rolin L. Wade is an employee of IQVIA. Xin Wang and Timothy Hill were employees of IQVIA at the time of this research. IQVIA was contracted by Amgen to conduct this study. Mary Oates is an employee and stockholder of Amgen. Xiaoqing Xu was an employee of Amgen at the time of this research.

Figures

Fig. 1
Fig. 1
Patient attrition
Fig. 2
Fig. 2
Distribution of index fracture
See this image and copyright information in PMC

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