• Something wrong with this record ?

Pharmacological management of osteoporosis in nursing home residents: the Shelter study

AM. Makan, HV. Hout, G. Onder, H. van der Roest, H. Finne-Soveri, E. Topinková, M. Denkinger, J. Gindin, R. van Marum

. 2021 ; 143 (-) : 184-189. [pub] 20201102

Language English Country Ireland

Document type Comparative Study, Journal Article

Persistent link   https://www.medvik.cz/link/bmc21011676

OBJECTIVE: To prevent osteoporotic fractures in nursing home residents a combination of bisphosphonates, calcium and vitamin D is recommended. This study assessed the prevalence of pharmacological osteoporosis prevention in nursing home residents from eight countries, and assessed its association with patient characteristics. DESIGN: Cross-sectional analyses of the SHELTER study data. We assessed the overall prevalence of osteoporosis medication (OM) use (vitamin D, calcium and bisphosphonates) in residents stratified for falls and fractures over last 30 days, health instability with high mortality risk, cognitive impairment, and dependence in walking. SETTING AND PARTICIPANTS: Nursing home residents in the Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel. RESULTS: Of 3832 eligible residents, vitamin D, calcium and bisphosphonates were used by 16.2%, 10.4%, and 4.5% respectively. All 3 classes of OM together were used by 1.5% of all residents. Of residents with a recent fracture, 9.5% used a bisphosphonate (2.7% all 3 OMs). In patients with recent falls, 20.8% used vitamin D and 15.3% calcium. In residents with severe cognitive impairment, 15.5% used vitamin D and 9.3% used calcium. Of the bisphosphonate users, 33.7% also used both vitamin D and calcium, 25.8% used only calcium in addition and 17.4% only vitamin D in addition. The use of any OM varied widely across countries, from 66.8% in Finland to 3.0% in Israel. CONCLUSIONS AND IMPLICATIONS: We found substantial pharmacological under-treatment of prevention of osteoporosis in residents with recent falls, fractures and dependence in walking. Only two-thirds of bisphosphonate users also took a vitamin D-calcium combination, despite guideline recommendations. On the other hand, possible over-treatment was found in residents with high mortality risk in whom preventive pharmacotherapy might not have still been appropriate. The prevalence of pharmacological prevention of osteoporosis differed substantially between countries. Efforts are needed to improve pharmacotherapy in residents.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc21011676
003      
CZ-PrNML
005      
20210507103445.0
007      
ta
008      
210420s2021 ie f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.maturitas.2020.10.020 $2 doi
035    __
$a (PubMed)33308627
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a ie
100    1_
$a Makan, Alireza Malek $u Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, the Netherlands; Care Group Coloriet, Lelystad, the Netherlands; Care group Almere, Almere, the Netherlands
245    10
$a Pharmacological management of osteoporosis in nursing home residents: the Shelter study / $c AM. Makan, HV. Hout, G. Onder, H. van der Roest, H. Finne-Soveri, E. Topinková, M. Denkinger, J. Gindin, R. van Marum
520    9_
$a OBJECTIVE: To prevent osteoporotic fractures in nursing home residents a combination of bisphosphonates, calcium and vitamin D is recommended. This study assessed the prevalence of pharmacological osteoporosis prevention in nursing home residents from eight countries, and assessed its association with patient characteristics. DESIGN: Cross-sectional analyses of the SHELTER study data. We assessed the overall prevalence of osteoporosis medication (OM) use (vitamin D, calcium and bisphosphonates) in residents stratified for falls and fractures over last 30 days, health instability with high mortality risk, cognitive impairment, and dependence in walking. SETTING AND PARTICIPANTS: Nursing home residents in the Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel. RESULTS: Of 3832 eligible residents, vitamin D, calcium and bisphosphonates were used by 16.2%, 10.4%, and 4.5% respectively. All 3 classes of OM together were used by 1.5% of all residents. Of residents with a recent fracture, 9.5% used a bisphosphonate (2.7% all 3 OMs). In patients with recent falls, 20.8% used vitamin D and 15.3% calcium. In residents with severe cognitive impairment, 15.5% used vitamin D and 9.3% used calcium. Of the bisphosphonate users, 33.7% also used both vitamin D and calcium, 25.8% used only calcium in addition and 17.4% only vitamin D in addition. The use of any OM varied widely across countries, from 66.8% in Finland to 3.0% in Israel. CONCLUSIONS AND IMPLICATIONS: We found substantial pharmacological under-treatment of prevention of osteoporosis in residents with recent falls, fractures and dependence in walking. Only two-thirds of bisphosphonate users also took a vitamin D-calcium combination, despite guideline recommendations. On the other hand, possible over-treatment was found in residents with high mortality risk in whom preventive pharmacotherapy might not have still been appropriate. The prevalence of pharmacological prevention of osteoporosis differed substantially between countries. Efforts are needed to improve pharmacotherapy in residents.
650    _2
$a úrazy pádem $7 D000058
650    _2
$a senioři $7 D000368
650    _2
$a senioři nad 80 let $7 D000369
650    _2
$a vápník dietní $x terapeutické užití $7 D002136
650    _2
$a bisfosfonáty $x terapeutické užití $7 D004164
650    _2
$a spotřeba léčiv $x statistika a číselné údaje $7 D004363
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a pečovatelské domovy $x statistika a číselné údaje $7 D009735
650    _2
$a osteoporóza $x farmakoterapie $x prevence a kontrola $7 D010024
650    _2
$a osteoporotické fraktury $x prevence a kontrola $7 D058866
650    _2
$a vitamin D $x terapeutické užití $7 D014807
650    _2
$a vitaminy $x terapeutické užití $7 D014815
651    _2
$a Evropa $7 D005060
651    _2
$a Izrael $7 D007557
655    _2
$a srovnávací studie $7 D003160
655    _2
$a časopisecké články $7 D016428
700    1_
$a Hout, Hein van $u Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, the Netherlands. Electronic address: hpj.vanhout@amsterdamumc.nl
700    1_
$a Onder, Graziano $u Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
700    1_
$a van der Roest, Henriëtte $u Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, the Netherlands
700    1_
$a Finne-Soveri, Harriet $u Department of Welfare, National Institute for Health and Welfare, Finland
700    1_
$a Topinková, Eva $u Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic; Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
700    1_
$a Denkinger, Michael $u Agaplesion Bethesda Clinic, Geriatric Centre Ulm/Alb-Donau, Ulm University, Ulm, Germany
700    1_
$a Gindin, Jacob $u Department of Geriatrics, Assuta Medical Centers, Tel Aviv, Israel
700    1_
$a van Marum, Rob $u Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam University Medical Centres, Vrije Universiteit, Amsterdam, the Netherlands; Department of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
773    0_
$w MED00003202 $t Maturitas $x 1873-4111 $g Roč. 143, č. - (2021), s. 184-189
856    41
$u https://pubmed.ncbi.nlm.nih.gov/33308627 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y p $z 0
990    __
$a 20210420 $b ABA008
991    __
$a 20210507103444 $b ABA008
999    __
$a ok $b bmc $g 1650140 $s 1132055
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2021 $b 143 $c - $d 184-189 $e 20201102 $i 1873-4111 $m Maturitas $n Maturitas $x MED00003202
LZP    __
$a Pubmed-20210420
Back

Find record

Citation metrics

Archiving options