Status of and factors associated with anti-osteoporosis drug use among elderly patients with hip fracture: A nationwide cross-sectional study

Background Anti-osteoporosis drug use is an effective way to prevent subsequent fractures among hip fracture patients. The associated risk factors of anti-osteoporosis drug use in elderly hip fractures patients are well investigated.

Objective To investigate the associated risk factors of anti-osteoporosis drug use in elderly hip fracture patients.

Methods  Osteoporotic fractures patients in 594 hospitals in 31 provinces/ autonomous regions/ municipalities were investigated using a multistage, cluster-based, cross-sectional survey method. The present study included patients over 60 years old who underwent hip fracture surgery. The basic information of patients and fracture management information in hospitals were collected. Multivariate logistic regression was applied to identify risk factors associated with anti-osteoporosis drug use.

Results This study included 4 369 patients, with a mean age of 76.49 ± 8.78 years. The proportion of anti-osteoporosis drug use was 21.8%. Associated risk factors of anti-osteoporosis drug use included: region (south China vs east China, OR=0.64, 95% CI: 0.45-0.91; central China vs east China, OR=0.50, 95% CI: 0.37-0.68), hospital category (general hospitals vs specialized hospitals, OR=1.77, 95% CI: 1.22-2.57), annual household income (100 000-200 000 CNY vs <100 000 CNY, OR=1.48, 95% CI: 1.21-1.82; 200 000 – 300 000 CNY vs <100 000 CNY, OR=2.11, 95% CI: 1.51-2.94; >300 000 CNY vs <100 000 CNY, OR=2.14, 95% CI: 1.48-3.09), patients with concomitant pneumonia (OR=1.99, 95% CI: 1.43-2.78), patients with concomitant stroke (OR=0.65, 95% CI: 0.45-0.93), patients with concomitant eye disease (OR=1.84, 95% CI: 1.10-3.06), history of fracture risk assessment (OR=1.40, 95% CI: 1.02-1.93), osteoporosis knowledge (OR=1.26, 95% CI: 1.06-1.50), calcium or vitamin D supplements (OR=5.32, 95% CI: 4.18-6.76), and bone mineral density testing (OR=2.94, 95% CI: 2.46-3.51).

Conclusion The proportion of anti-osteoporosis drug use is low in elderly hip fractures patients. Risk factors associated with anti-osteoporosis drug use are region, hospital category, annual household income, comorbidities, history of fracture risk assessment, osteoporosis knowledge, calcium or vitamin D supplements, and bone mineral density testing.