| Pharmacological management of osteoporosis in nursing home populations: a systematic review. | |
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MedLine Citation:
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PMID: 19207148 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Nursing home (NH) residents fall 11 times as frequently as their age-matched community-dwelling counterparts. The benefits of fall prevention strategies and hip protectors in terms of fracture risk in this setting are unclear. Moreover, there is no consensus on the efficacy of osteoporosis medication in NH residents. A systematic review was conducted to evaluate the efficacy of medications for osteoporosis in this population and to examine utilization studies in the NH setting to define prescribing practices. Electronic searches of MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials were supplemented with a hand search of bibliographies. All English-language studies published between January 1, 1974, and December 31, 2006, that studied osteoporosis pharmacotherapy in the NH environment were obtained, and studies of medication benefits and utilization patterns were identified. No restrictions were placed on study method. Studies required inclusion of NH patients and extractable data with bone mineral density (BMD) or fracture outcomes. Forty full-text articles were retrieved, of which 15 studies met selection criteria. In the nine studies examining medication effects, calcium (1,200 mg) and vitamin D (800 IU) supplementation were shown to reduce fracture risk and improve BMD. One study supported the role of alendronate, but none documented the utility of raloxifene, calcitonin, or teriparatide in NH residents. All six medication utilization studies reported infrequent use of osteoporosis medications (9-25%). Prescribing for elderly NH patients is difficult, considering the risk:benefit ratio and issues of longevity, but these medications may be underused in the NH environment. |
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Authors:
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Seema Parikh; Jerry Avorn; Daniel H Solomon |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Journal of the American Geriatrics Society Volume: 57 ISSN: 1532-5415 ISO Abbreviation: J Am Geriatr Soc Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-02-11 Completed Date: 2009-03-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7503062 Medline TA: J Am Geriatr Soc Country: United States |
Other Details:
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Languages: eng Pagination: 327-34 Citation Subset: IM |
Affiliation:
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Brigham and Womens' Hospital and Harvard Medical School, Boston, Massachusetts, USA. Sparikh3@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Humans Nursing Homes* Osteoporosis / drug therapy* |
| Grant Support | |
ID/Acronym/Agency:
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AR-047782/AR/NIAMS NIH HHS; AR-055989/AR/NIAMS NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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