Practice pattern variation in the prevention and treatment of osteoporosis.

Prevention and treatment of osteoporosis will be of increasing importance as the mean age of the world population rapidly increases in the coming decades. Nearly half of postmenopausal women not already diagnosed with osteoporosis have significantly low bone mineral density and are at increased risk of fracture, yet this risk is often unrecognized and untreated. Postmenopausal women who have experienced fractures of the hip, vertebra, and wrist and patients using glucocorticoids are at highest risk of fractures but often remain untested and untreated for osteoporosis. Because of the rising societal costs of osteoporosis anticipated in coming years, an improved understanding of the predictors of practice pattern variations and interventions designed to improve underutilization of appropriate care are important to clinicians, health services researchers, and policy makers.