Is there a disparity in osteoporosis referral and treatment among people with affective disorders?: A ten-year data linkage study

Ruimin Ma; Eugenia Romano; Mark Ashworth; Davy Vancampfort; Marco Solmi; Lee Smith; Nicola Veronese; Christoph Mueller; Robert Stewart; Brendon Stubbs

doi:10.1016/j.genhosppsych.2025.02.009

Is there a disparity in osteoporosis referral and treatment among people with affective disorders? A ten-year data linkage study

Ruimin Ma, Eugenia Romano, Mark Ashworth, Davy Vancampfort, Marco Solmi, Lee Smith, Nicola Veronese, Christoph Mueller, Robert Stewart, Brendon Stubbs

Research output: Contribution to journal › Article › peer-review

Abstract

AIMS: People with affective disorders (AD) are at increased risk of osteoporosis and fractures. Osteoporosis treatment/referral is thus essential in this population. However, it is unclear whether osteoporosis treatment/referral differs between those with and without AD. This retrospective cohort study compared osteoporosis treatment/referral in people with and without AD across linked primary and mental health care data.

METHODS: People with AD (ICD-10 codes F3*) between 1.5.2009-30.11.2019, aged 18+ at first diagnosis, from Lambeth, South London were randomly matched 1:4 to healthy controls based on age band and gender. Outcomes including treatments (prescription of calcium, calcium with vitamin D) and referral (referrals for osteoporosis screening and/or prevention) were analysed using conditional and multivariable logistic regression analyses.

RESULTS: People with AD (n = 23,932) were more likely than controls (n = 76,593) to have a recorded prescription of calcium (odds ratio [OR] = 1.64, 95 % confidence interval [CI] 1.40-1.92) and calcium with vitamin D (OR = 2.25, 95 % CI 2.10-2.41), and be referred for osteoporosis screening (OR = 1.87, 95 % CI 1.76-1.99) within 2 years after the date of the first AD diagnosis in adjusted analyses. Older age, female sex, having an ethnic minority background, Class A analgesics use were significant predictors for all osteoporosis management pathways within AD patients.

CONCLUSION: Findings from the present study suggest that compared to the general population, people with AD are more likely to receive osteoporosis screening/treatments. Whether this increased screening/treatment is sufficient to reduce the burden of osteoporosis and fractures in this population is unclear and warrants further consideration.

Original language	English
Pages (from-to)	56-62
Number of pages	7
Journal	GENERAL HOSPITAL PSYCHIATRY
Volume	94
Early online date	15 Feb 2025
DOIs	https://doi.org/10.1016/j.genhosppsych.2025.02.009
Publication status	Published - 1 May 2025

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10.1016/j.genhosppsych.2025.02.009Licence: CC BY

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@article{b6e44376f024468e907ee3c40d97185e,

title = "Is there a disparity in osteoporosis referral and treatment among people with affective disorders?: A ten-year data linkage study",

abstract = "AIMS: People with affective disorders (AD) are at increased risk of osteoporosis and fractures. Osteoporosis treatment/referral is thus essential in this population. However, it is unclear whether osteoporosis treatment/referral differs between those with and without AD. This retrospective cohort study compared osteoporosis treatment/referral in people with and without AD across linked primary and mental health care data.METHODS: People with AD (ICD-10 codes F3*) between 1.5.2009-30.11.2019, aged 18+ at first diagnosis, from Lambeth, South London were randomly matched 1:4 to healthy controls based on age band and gender. Outcomes including treatments (prescription of calcium, calcium with vitamin D) and referral (referrals for osteoporosis screening and/or prevention) were analysed using conditional and multivariable logistic regression analyses.RESULTS: People with AD (n = 23,932) were more likely than controls (n = 76,593) to have a recorded prescription of calcium (odds ratio [OR] = 1.64, 95 % confidence interval [CI] 1.40-1.92) and calcium with vitamin D (OR = 2.25, 95 % CI 2.10-2.41), and be referred for osteoporosis screening (OR = 1.87, 95 % CI 1.76-1.99) within 2 years after the date of the first AD diagnosis in adjusted analyses. Older age, female sex, having an ethnic minority background, Class A analgesics use were significant predictors for all osteoporosis management pathways within AD patients.CONCLUSION: Findings from the present study suggest that compared to the general population, people with AD are more likely to receive osteoporosis screening/treatments. Whether this increased screening/treatment is sufficient to reduce the burden of osteoporosis and fractures in this population is unclear and warrants further consideration.",

author = "Ruimin Ma and Eugenia Romano and Mark Ashworth and Davy Vancampfort and Marco Solmi and Lee Smith and Nicola Veronese and Christoph Mueller and Robert Stewart and Brendon Stubbs",

year = "2025",

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doi = "10.1016/j.genhosppsych.2025.02.009",

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T1 - Is there a disparity in osteoporosis referral and treatment among people with affective disorders?

T2 - A ten-year data linkage study

AU - Ma, Ruimin

AU - Romano, Eugenia

AU - Ashworth, Mark

AU - Vancampfort, Davy

AU - Solmi, Marco

AU - Smith, Lee

AU - Veronese, Nicola

AU - Mueller, Christoph

AU - Stewart, Robert

AU - Stubbs, Brendon

PY - 2025/5/1

Y1 - 2025/5/1

N2 - AIMS: People with affective disorders (AD) are at increased risk of osteoporosis and fractures. Osteoporosis treatment/referral is thus essential in this population. However, it is unclear whether osteoporosis treatment/referral differs between those with and without AD. This retrospective cohort study compared osteoporosis treatment/referral in people with and without AD across linked primary and mental health care data.METHODS: People with AD (ICD-10 codes F3*) between 1.5.2009-30.11.2019, aged 18+ at first diagnosis, from Lambeth, South London were randomly matched 1:4 to healthy controls based on age band and gender. Outcomes including treatments (prescription of calcium, calcium with vitamin D) and referral (referrals for osteoporosis screening and/or prevention) were analysed using conditional and multivariable logistic regression analyses.RESULTS: People with AD (n = 23,932) were more likely than controls (n = 76,593) to have a recorded prescription of calcium (odds ratio [OR] = 1.64, 95 % confidence interval [CI] 1.40-1.92) and calcium with vitamin D (OR = 2.25, 95 % CI 2.10-2.41), and be referred for osteoporosis screening (OR = 1.87, 95 % CI 1.76-1.99) within 2 years after the date of the first AD diagnosis in adjusted analyses. Older age, female sex, having an ethnic minority background, Class A analgesics use were significant predictors for all osteoporosis management pathways within AD patients.CONCLUSION: Findings from the present study suggest that compared to the general population, people with AD are more likely to receive osteoporosis screening/treatments. Whether this increased screening/treatment is sufficient to reduce the burden of osteoporosis and fractures in this population is unclear and warrants further consideration.

AB - AIMS: People with affective disorders (AD) are at increased risk of osteoporosis and fractures. Osteoporosis treatment/referral is thus essential in this population. However, it is unclear whether osteoporosis treatment/referral differs between those with and without AD. This retrospective cohort study compared osteoporosis treatment/referral in people with and without AD across linked primary and mental health care data.METHODS: People with AD (ICD-10 codes F3*) between 1.5.2009-30.11.2019, aged 18+ at first diagnosis, from Lambeth, South London were randomly matched 1:4 to healthy controls based on age band and gender. Outcomes including treatments (prescription of calcium, calcium with vitamin D) and referral (referrals for osteoporosis screening and/or prevention) were analysed using conditional and multivariable logistic regression analyses.RESULTS: People with AD (n = 23,932) were more likely than controls (n = 76,593) to have a recorded prescription of calcium (odds ratio [OR] = 1.64, 95 % confidence interval [CI] 1.40-1.92) and calcium with vitamin D (OR = 2.25, 95 % CI 2.10-2.41), and be referred for osteoporosis screening (OR = 1.87, 95 % CI 1.76-1.99) within 2 years after the date of the first AD diagnosis in adjusted analyses. Older age, female sex, having an ethnic minority background, Class A analgesics use were significant predictors for all osteoporosis management pathways within AD patients.CONCLUSION: Findings from the present study suggest that compared to the general population, people with AD are more likely to receive osteoporosis screening/treatments. Whether this increased screening/treatment is sufficient to reduce the burden of osteoporosis and fractures in this population is unclear and warrants further consideration.

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U2 - 10.1016/j.genhosppsych.2025.02.009

DO - 10.1016/j.genhosppsych.2025.02.009

M3 - Article

C2 - 39999528

SN - 0163-8343

VL - 94

SP - 56

EP - 62

JO - GENERAL HOSPITAL PSYCHIATRY

JF - GENERAL HOSPITAL PSYCHIATRY

ER -

Is there a disparity in osteoporosis referral and treatment among people with affective disorders? A ten-year data linkage study

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