Here’s news to share with women’s health groups: The Agency for Healthcare Research and Quality (AHRQ) has released the Spanish language version of Osteoporosis Treatments that Help Prevent Broken Bones: A Guide for Women After Menopause (PDF). For a free print copy, call the AHRQ Publications Clearinghouse: (800) 358-9295
The guide covers prescription drugs available to treat osteoporosis, along with their potential side effects and risks. Our Bodies Ourselves Executive Director Judy Norsigian reviewed the content for the English language version, which was released in June 2008.
Osteoporosis is more likely to affect women after menopause, mostly because the body has less estrogen. Smaller and thinner women are more at risk, as are women who have family members who had osteoporosis and broke a bone. Certain medicines, such as thyroid medicine or steroids, are also risk factors.
Earlier this summer, AHRQ, which is the health services research arm of the U.S. Department of Health and Human Services, released a statistical brief concerning U.S. hospitalizations due to osteoporosis and injury. Between 1995 and 2006, there was a 55 percent increase in the rate of patients hospitalized for treatment of hip, pelvis and other fractures associated with osteoporosis. The more than 254,000 hospital stays totaled $2.4 billion in costs in 2006.
Other highlights from the brief:
- Injuries were noted in one-fourth of all stays with an osteoporosis diagnosis. Pathological fractures (i.e., spontaneous and stress fractures), hip fractures, and fractures of the vertebrae, ribs, and pelvis were the most frequently occurring injuries among these patients.
- Nearly 90 percent of stays involving an injury likely due to osteoporosis occurred among patients 65 years and older; 37 percent occurred among patients 85 and older.
- Females accounted for nearly 89 percent of injurious osteoporosis stays and had hospitalization rates that were more than six times higher than males.
- The Midwest had the highest rate of injurious osteoporosis hospitalizations (107 stays per 100,000 population), while the West had the lowest rate (68 stays per 100,000 population).
- Treatments of hip and leg fractures and dislocations were performed in 16.4 percent of all injurious osteoporosis stays, and 8.1 percent of these stays noted a hip replacement.
Our Bodies Ourselves has posted clinical recommendations (pdf) for when women should be screened, who should consider screening, and what kind of prevention and treatments can be effective. The guidelines were written by the Harvard Vanguard Medical Associates.
In related news, The New York Times this week looks at the dispute over how to address osteopenia, bone density that is below what is considered normal, but not low enough to be considered osteoporosis. Kate Murphy writes:
Millions of people worldwide, most of them women, have been told they have osteopenia and should take drugs to inhibit bone loss. But the drugs carry risks, so many public-health experts say the diagnosis often does more harm than good.
Now the World Health Organization has developed an online tool meant to help doctors and patients determine when treatment for deteriorating bones is appropriate.
A preliminary version of the tool, called FRAX, was released last year and can be found at www.shef.ac.uk/FRAX/index.htm. A revised version is to be released later this year.
But FRAX is proving almost as controversial as the diagnosis of osteopenia. While some experts applaud it for taking factors besides bone density into account, others say that the formula on which the tool is based is faulty and that the advised threshold for medication is too low.
“FRAX is coming from the same people who came up with osteopenia in the first place,” said Dr. Nelson Watts, director of Bone Health and Osteoporosis Center at the University of Cincinnati, who said the diagnosis unnecessarily frightened women and should be abolished.