Background/Purpose: Osteoporotic fractures are an important public health burden, and with an increasing aging population, the number of Americans at risk of fractures is projected to increase 33% by 2030. The objective of this study was to evaluate osteoporosis management in Medicare enrollees.

Methods: This study included Medicare fee-for-service (FFS) members with a closed fragility (or osteoporosis-related) fracture between 01/01/2010-12/31/2014. Cohort characteristics were computed yearly for 2010-2014 in order to examine secular trends in osteoporosis management. Inclusion criteria for cohort eligibility was age ≥65 at index date, continuous enrollment in Medicare FFS with medical and pharmacy benefits for ≥1 year before index date. Patients with Paget’s disease or malignancy (except non-melanoma skin cancer) at baseline were excluded.

Results: Of 18,936,386 beneficiaries, 885,676 had fracture(s) and met eligibility criteria. Average age was 80.5(±8.4) years, 90.9% were white, and 93.8% female. Over half of patients in each yearly cohort had a comorbidity or a medication that increased fall risk, with approximately 50% of patients using opioids. Despite increased fall risk, osteoporosis diagnosis, screening, and treatment rates at baseline were low and decreased from 2010-2014: DXA: 25%, 24%, 23%, 22%,16%; diagnosis: 7%, 6%, 6%, 5%, 4%; treatment: 29%, 24%, 20%, 16%, 11%. A trend toward lower OP diagnosis and treatment utilization over time was observed.

Conclusion: These findings suggest continued and perhaps worsening osteoporotic fracture management over time. Opportunities exist to better identify and treat patients who have an increased risk of fracture.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/worsening-trends-in-osteoporosis-management-in-the-medicare-population-2010-2014/