Review on November 10, 2009
Lee et al. 2002's study: "Patterns of Pharmacotherapy and Counseling for Osteoporosis Management in Visits to US Ambulatory Care Physicians by Women" discusses the link between osteoporosis and menopause, along with the rate at which women going through menopause seek treatment. Osteoporosis is the most common bone disease in the United States and is responsible for 1.5 million bone fractures each year. Two of the most important risk factors for osteoporosis are being female sex and of advanced age, which leads some to consider osteoporosis as a side effect of menopause. Women experiencing menopause should also take note because estrogen deficiency is seen as a significant contributor to osteoporosis development. This is born out by the data. Women who are sixty-five years and older, who are presumable either in the post-menopause category, experience a significantly higher rate of osteoporosis than younger women. Thirty-three percent of women in this post-menopause age group have experienced at least 1 vertebral fracture during their lifetime.
For women who are experiencing menopause and are at risk for osteoporosis, antiosteoporosis medications (AOMs) are one of the recommended options. AOMs generally include calcium, vitamin D and estrogen replacement. This study sought to estimate the prevalence at which women of menopause age visit their doctor in relation to AOM medication for osteoporosis. The study hypothesized that certain characteristics, such as age, race, insurance type and physician specialty, would play a role in the frequency of these visits. It also monitored these doctors' visits to see whether the doctor counseled them on lifestyle modifications as well. This is primarily a descriptive study about osteoporosis and menopause
The study evaluated recent national data on patterns of AOM use. They also analyzed data from the National Ambulatory Medical Care Survey about visits made by women forty years and older between the years of 1997 and 1998. These women were studied because the age distribution of menopause is typically between forty to fifty-eight years. Therefore, women older than forty are those who usually run the greatest risk for osteoporosis. The results were that 10% of the visits that women made annually were associated with AOM therapy. Women in their 50s and 60's were more likely to partake in these types of visits. Being White or having private insurance or Medicare was also more strongly linked with having a doctor's visit about AOM therapy. Women at AOM visits were also twice as likely to receive counseling about lifestyle modifications than women did not have these types of appointments.
It is estimated that twenty million women of menopause age in the United States have osteoporosis or its milder form, osteopenia (bone mineral density that is lower than normal but not weak enough to qualify as osteoporosis.) It would be interesting to compare the inequalities in receiving treatment for osteoporosis and information about treatment with the knowledge that White women, Asian women and urban women are diagnosed with osteoporosis at a higher rate. It is also interesting to ponder that ninety three percent of women going through menopause that have osteoporosis are completely unaware of their condition.
- PharmD, PhD, Lee, Euni; PharmD Zuckerman, Ilene H.; PhD Weiss, Sheila R. "Patterns of Pharmacotherapy and Counseling for Osteoporosis Management in Visits to US Ambulatory Care Physicians by Women." (2002). Arch Intern Med.