Jeffrey Curtis, MD, MS, MPH, offers his thoughts on the most effective methods to address the underdiagnosis and undertreatment of osteoporosis in older male patients.
Often times in medicine, a topic or cause becomes so large it can cast a proverbial shadow on other aspects of care. In rheumatology, this has caused gender disparities in the diagnosis and treatment of osteoporosis.
While bone health in women is a well-known issue, the lack of public interest and emphasis has caused the management of osteoporosis in men has caused it to under the radar for many patients and clinicians. In a recent study presented at ACR Convergence, investigators from the University of Alabama at Birmingham sought to quantify the apparent undertreatment and underdiagnosis of osteoporosis in older men.
Using Medicare fee-for-service beneficiaries, investigators identified a cohort of more than 9000 patients aged 65 or older with a closed-fragility or osteoporosis-related fracture during a 4-year period. Upon analysis, investigators found 62.8% of patients had a history of musculoskeletal pain and 48.5% had a history of opioid use 1 year prior to their index fracture, but only 6% had a bone mineral density test in the past 2 years.
Overall, 92.8% did not have a claim for diagnosis or treatment of osteoporosis at baseline. Investigators also noted a trend in declining DXA scans from 2012-2014 (65-69 years, 6.3 to 5.5%; 70-74 years, 4.7 to 4.0%) with this trend being even more pronounced in those 75 or older (6.0 to 4.3%).
To learn more about the topic, we reached out to lead investigator Jeffrey Curtis, MD, MS, MPH.
This study, “Characterization of Older Male Patients with a Fragility Fracture,” was presented at ACR Convergence.