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Evaluation of a program of integrated care to reduce recurrent osteoporotic fractures
Author(s) -
Goltz Lisa,
Degenhardt Gabriel,
Maywald Ulf,
Kirch Wilhelm,
Schindler Christoph
Publication year - 2013
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3399
Subject(s) - medicine , incidence (geometry) , osteoporosis , medical prescription , placebo , clinical trial , pharmacoepidemiology , physical therapy , health care , population , emergency medicine , randomized controlled trial , alternative medicine , environmental health , physics , pathology , optics , economics , pharmacology , economic growth
Purpose To evaluate the outcomes of patients participating in a program of integrated care for osteoporosis in terms of medication supply, fracture incidence and expenses. Methods Outcomes were assessed from secondary data provided by the AOK PLUS health insurance for 2455 participants of the program and the same number of matched controls who were also diagnosed with osteoporosis but did not participate in the program. Supply with Calcium and Vitamin D, antiresorptive agents and analgesics was assessed by defined daily doses. Osteoporotic fractures were identified by hospitalization data. Costs for fracture treatment, medication supply and additional expenses of the program were also included in the dataset. Results Patients enrolled in the program of integrated care received significantly more medication to treat osteoporosis than controls. There was no significant reduction in fracture incidence among participants of integrated care, but a reduced need of analgesics was noted. Additional costs for patients enrolled in the program were caused by a higher number of drug prescriptions, higher costs for stationary treatment and additional expenses for program related care and diagnostics. Conclusions The program of integrated care was not found to be effective in reducing recurrent fractures. Cost effectiveness defined as a reduced rate of fractures in integrated care patients could not be shown by the assessed outcome measures. This missing reduction in fracture incidence may be explained by a non‐sufficient improvement – compared to a placebo‐controlled clinical trial – in medication supply and non‐comparability of our real‐world patient population with highly controlled clinical trial participants. Copyright © 2013 John Wiley & Sons, Ltd.