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In a recent publication, Lee and colleagues, using data derived from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey from the US National Center for Health Statistics, evaluated changes in osteoporosis therapy in women aged ≥ 40 years, during the period January 1997 to December 2005 [1]. These office-based physician and hospital ambulatory clinics data were analyzed for visits in which anti-osteoporosis medication was prescribed, provided or continued, before and after initial publication of the Women’s Health Initiative (WHI) results. These visits were estimated in 6-month intervals, the first 11 before the WHI and the last seven after the WHI publication. Results were extrapolated to a national estimate. Principal findings include that the overall prevalence of prescribing of anti-osteoporosis medication did not significantly differ before and after the WHI. However, the prescribing of estrogen decreased while that of bisphosphonates, calcium and vitamin D increased in both office-based physician and hospital-based clinic settings. The adjusted odds ratios and 95% confidence intervals for the likelihood of non-estrogen, anti-osteoporosis therapy (excluding calcium and vitamin D) after the WHI were 2.49 (2.04–3.04) and 2.42 (1.67–3.50), office-based and hospital-based, respectively, compared with 1.00 before the WHI. Additionally, visits by black women had a lower likelihood of being associated with non-estrogen therapy than other racial groups, although this difference was significantly different only in the hospital-based clinic group.


  • James H. Pickar
    Adjunct Associate Professor, Obstetrics and Gynecology, Columbia University Medical Center, New York, USA


  1. Lee E, Maneno MK, Wutoh AK, Zuckerman IH.  Long-term effects of the Womens Health Initiative study on antiosteoporosis medication prescribing. J Womens Health 2010;19:847-54. Published May 2010.
  2. Dell RM, Greene D, Anderson D, Williams K. Osteoporosis disease management: what every orthopaedic surgeon should know. J Bone Joint Surg Am 2009;91(Suppl 6):79-86.
  3. Islam S, Liu Q, Chines A, Helzner E. Trend in incidence of osteoporosis-related fractures among 40- to 69-year-old women: analysis of a large insurance claims database, 20002005. Menopause 2009;16:77-83.
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