Primary Health Care Research & Development

Short Report

Osteoporosis prescribing trends in primary care: a population-based retrospective cohort study

Li Wanga1, C. Shawn Tracya1 c1, Rahim Moineddina1a2a3 and Ross E.G. Upshura1a2a3

a1 Primary Care Research Unit, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

a2 Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

a3 Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada


Background Osteoporosis is a highly prevalent and costly disease associated with aging. Previous studies have indicated low intervention rates in primary care; however, there is little research investigating the prescribing patterns of osteoporosis medications by primary-care physicians.

Methods We conducted a population-based retrospective cohort study to examine trends in osteoporosis medication utilization in primary care between 1 January 2000 and 31 December 2009 in Ontario, Canada. All Ontario residents aged 65 years or older and eligible for public health coverage were included in the analysis (∼1.46 million residents in 2000, ∼1.75 million residents in 2009).

Results Analysis of 10-year data indicates a trend toward higher utilization of osteoporosis medications among elderly primary-care patients. In 2000, 100 038 unique patients were prescribed an osteoporosis medication by a family physician; by 2009, this number increased to 301 679. Age-group analyses suggest an inverted U-shaped pattern, whereby utilization rates increase with advancing age and then decline for the oldest age groups. Utilization rates were the lowest for the 100+ age group.

Conclusions This study indicates increased utilization of osteoporosis-related medications among elderly primary-care patients over a recent 10-year time period. It is unclear whether the observed increase in utilization is due to higher rates of osteoporosis. Further research is needed to determine the appropriateness of this higher utilization.

(Received December 02 2011)

(Revised February 03 2012)

(Accepted February 06 2012)

(Online publication April 23 2012)


  • bisphosphonates;
  • family physician;
  • osteoporosis;
  • primary care


c1 Correspondence to: C. Shawn Tracy, Research Associate, Primary Care Research Unit, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room E3-49, Toronto, ON, Canada M4N 3M5. Email: