Use of antiosteoporotic medication in the Danish ROSE population-based screening study

Area of Science:

• Gerontology
• Public Health
• Pharmacology

Background:

• Osteoporosis management is crucial for preventing fractures in older adults.
• Population-based screening strategies aim to identify at-risk individuals for timely intervention.
• Understanding medication uptake, adherence, and persistence is vital for effective osteoporosis treatment.

Purpose of the Study:

• To evaluate the impact of a risk-stratified screening program on antiosteoporotic medication use.
• To compare medication prescription, adherence, and persistence between screening and usual care groups.
• To identify factors influencing treatment initiation and adherence in osteoporosis management.

Main Methods:

• The Danish Osteoporosis Strategy Evaluation (ROSE) study randomized women aged 65-81 to a two-step screening (FRAX followed by DXA) or usual care.
• This sub-study analyzed medication redemption rates, adherence, and persistence using Danish registers.
• The intention-to-treat population was analyzed to assess the screening program's impact.

Main Results:

• The screening group showed significantly higher initiation of antiosteoporotic medication compared to usual care.
• Higher age was associated with increased likelihood of starting medication.
• A substantial proportion (31.7%) of participants advised to initiate treatment did not follow the recommendation, with low comorbidity scores linked to higher initiation but lower adherence.

Conclusions:

• Osteoporosis screening using FRAX and DXA effectively increased antiosteoporotic medication use.
• Screening did not significantly alter medication adherence or persistence rates.
• A significant number of individuals advised to commence osteoporosis treatment opted against it, highlighting a gap in treatment initiation.