Incidencia de la fractura de cadera osteoporótica en Galicia en relación con la dispensación de medicamentos con indicación en su prevención y tratamiento

Abstract

Objective To analyse the evolution in the incidence of hip fractures in our autonomous community in relationship to the trend in the prescription of medicines for the prevention and/or treatment of osteoporotic hip fracture. Design Descriptive observational ecological study. Setting Public health network in the whole autonomous community over five years, from 1st January 2004 to 31st December 2008. Participants Patients over 44 years old admitted with osteoporotic hip fracture. Medicines dispensed at a pharmacy which are indicated for the prevention of osteoporotic hip fractures (alendronate, risedronate and strontium ranelate). Exclusion: Open fractures, hospital or private or prescriptions. Measurements Incidence (number of new cases of hip fractures occurring in a year), Incidence rate (incidence per 100,000 inhabitants), Dispersion rate (number of packets dispensed per year per 100,000 inhabitants) and Hazard ratio (HR, ratio between the rate of last year and first). Annual rates were calculated standardised by the direct method. Results We identified 12,137 hospital admissions for fractured hip (2,792 men and 9,345 women). Sub-capital fractures: Mean Incidence Rate (MIR)=86.14,95%CI[61.85–110.42]; HR=1.22, 95%CI[0.82–1.63] (men) and MIR=180.88,95%CI[124.74–237.02]; HR=1.08,95%CI[0.73–1.43] (women). Trochanteric fractures: MIR=56.30,95%CI[39.18–73.42], HR=1.04,95%CI[0.75–1.34] (men) and MIR=136.51,95%CI[90.23–182.78]; HR=1.12,95%CI[0.89–1.35] (women). Subtrochanteric fractures: MIR=8.92,95%CI[6.52–11.32]; HR=1.26,95%CI[0.05–2.46] (men) and MIR=22.91,95%CI[15.24–30.58]; HR=1.08,95%CI[0.57–1.58] (women). Total HR fractures=1.07, 95%CI[0.92–1.23] (men) and 0.99,95%CI[0.83–1.17] (women). Drug dispensing (2008–2004): HR alendronate=1.30; HR risedronate=1.92; HR strontium ranelate=10.38. Conclusion Over five years the dispensing of drugs by the public health service has multiplied for the prevention and treatment of hip fractures while the incidence has remained unaltered.