Low rates of bone mineral density measurement in Medicare beneficiaries with prostate cancer initiating androgen deprivation therapy.
Low rates of bone mineral density measurement in Medicare beneficiaries with prostate cancer initiating androgen deprivation therapy.
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DOI：
10.1007/s00520-013-2008-z
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发表时间：
2014-02
影响因子：
3.1
通讯作者：
Elting, Linda S.
中科院分区：
文献类型：
--
作者：
Suarez-Almazor, Maria E.;Peddi, Prashanth;Luo, Ruili;Nguyen, Hoang T.;Elting, Linda S.
前列腺癌患者接受雄激素剥夺治疗（ADT）有骨质流失和骨折的风险。我们的目的是确定德克萨斯州患有前列腺癌的医疗保险受益人在开始ADT时是否接受了DXA扫描。我们在德克萨斯癌症登记/医疗保险关联数据库中确定了2005年至2007年间诊断为前列腺癌的男性，并接受了肠外ADT或睾丸切除术。我们在ADT开始前1年或开始后6个月内确定了DXA索赔。我们检查了纳入医疗保险d部分的患者亚组中骨保护剂的使用情况。我们使用多变量logistic回归模型来检查DXA使用的决定因素。分析包括2290名男性（2262名静脉ADT， 28名睾丸切除术）：197名（8.6%）在ADT开始前1年和开始后6个月内接受了DXA。75岁及以上的男性比66-74岁的男性更容易发生DXA （or:1.5; 95%CI:1.1-2.1）。生活在小城市地区的人比生活在大城市地区的人更不容易发生DXA （OR:0.40; 95%CI:0.19-0.82）。在1060名参加医疗保险D部分的男性中，59名（5.6%）在开始ADT时接受了骨保护剂；134例（12.6%）接受骨保护剂或行DXA。少于1 / 10的医疗保险受益人与前列腺癌开始ADT接受了DXA检查。土地利用的变化也与居住面积大小有关。在接受ADT的前列腺癌患者中使用DXA是否会导致骨折预防，还需要进一步的研究。
Men with prostate cancer who undergo androgen deprivation therapy (ADT) are at risk for bone loss and fractures. Our objective was to determine if Medicare beneficiaries with prostate cancer in the state of Texas underwent DXA scans when initiating ADT. We identified men diagnosed with prostate cancer between 2005 and 2007 in the Texas Cancer Registry/Medicare linked database, and who received parenteral ADT or orchiectomy. We identified DXA claims within 1 year before or 6 months after starting ADT. We examined use of bone conservation agents in the subgroup of patients enrolled in Medicare Part D. Multivariate logistic regression models were used to examine determinants of DXA use. The analysis included 2,290 men (2,262 parenteral ADT, 28 orchiectomy): 197 (8.6%) underwent DXA within 1 year before and 6 months after starting ADT. Men aged 75 years or older were more likely to undergo DXA than men aged 66-74 years (OR:1.5; 95%CI:1.1-2.1). Those living in small urban areas were less likely to undergo DXA than those in big areas (OR:0.40; 95%CI:0.19-0.82). Of the 1,060 men enrolled in Medicare Part D, 59 (5.6%) received bone conservation agents when starting ADT; 134 (12.6%) either received bone conservation agents or underwent DXA. Fewer than 1 in 10 Medicare beneficiaries with prostate cancer initiating ADT underwent a DXA exam. Variation in utilization was also related to residence area size. Further research is needed to identify whether the use of DXA in patients with prostate cancer receiving ADT will result in fracture prevention.
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影响因子：
39.2
作者：
Ito K;Elkin EB;Girotra M;Morris MJ
通讯作者：
Morris MJ
影响因子：
3
作者：
Basu, Sujit;Tindall, Donald J.
通讯作者：
Tindall, Donald J.
影响因子：
6.6
作者：
Melton, LJ;Alothman, KI;Zincke, H
通讯作者：
Zincke, H
DOI：
10.1111/j.1532-5415.2005.00618.x
发表时间：
2006-03-01
影响因子：
6.3
作者：
Feldstein, A;Elmer, PJ;Swain, MC
通讯作者：
Swain, MC
影响因子：
4
作者：
Demeter, S.;Leslie, W. D.;Reed, M.
通讯作者：
Reed, M.