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Osteoporosis International
Erschienen in:

14.05.2024 | Review

Examining treatment targets and equity in bone-active medication use within secondary fracture prevention: a systematic review and meta-analysis

verfasst von: Anum Ali, Ella Huszti, Shahryar Noordin, Usman Ali, Joanna E. M. Sale

Erschienen in: Osteoporosis International | Ausgabe 9/2024

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Abstract

Purpose

This systematic review seeks to evaluate the proportion of fragility fracture patients screened in secondary fracture prevention programs who were indicated for pharmacological treatment, received prescriptions for bone-active medications, and initiated the prescribed medication. Additionally, the study aims to analyze equity in pharmacological treatment by examining equity-related variables including age, sex, gender, race, education, income, and geographic location.

Methods

We conducted a systematic review to ascertain the proportion of fragility fracture patients indicated for treatment who received prescriptions and/or initiated bone-active medication through secondary fracture prevention programs. We also examined treatment indications reported in studies and eligibility criteria to confirm patients who were eligible for treatment. To compute the pooled proportions for medication prescription and initiation, we carried out a single group proportional meta-analysis. We also extracted the proportions of patients who received a prescription and/or began treatment based on age, sex, race, education, socioeconomic status, location, and chronic conditions.

Results

This review included 122 studies covering 114 programs. The pooled prescription rate was 77%, and the estimated medication initiation rate was 71%. Subgroup analysis revealed no significant difference in treatment initiation between the Fracture Liaison Service and other programs. Across all studies, age, sex, and socioeconomic status were the only equity variables reported in relation to treatment outcomes.

Conclusion

Our systematic review emphasizes the need for standardized reporting guidelines in post-fracture interventions. Moreover, considering equity stratifiers in the analysis of health outcomes will help address inequities and improve the overall quality and reach of secondary fracture prevention programs.
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Metadaten
Titel
Examining treatment targets and equity in bone-active medication use within secondary fracture prevention: a systematic review and meta-analysis
verfasst von
Anum Ali
Ella Huszti
Shahryar Noordin
Usman Ali
Joanna E. M. Sale
Publikationsdatum
14.05.2024
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 9/2024
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-024-07078-5

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