Osteoporosis International

, Volume 24, Issue 2, pp 433–442 | Cite as

Educational level and use of osteoporosis drugs in elderly men and women: a Swedish nationwide register-based study

  • J. W. WastessonEmail author
  • G. Ringbäck Weitoft
  • M. G. Parker
  • K. Johnell
Original Article



We examined educational disparities in use of osteoporosis drugs in a nationwide population of Swedes aged 75–89 years old. Individuals with high education were more likely to receive osteoporosis drug treatment than lower educated individuals, particularly among women.


This study aims to investigate whether educational level is associated with use of osteoporosis drugs in the general population of older men and women in Sweden, also after adjustment for fractures.


By record linkage of The Swedish Prescribed Drug Register, The Swedish Patient Register, and The Swedish Education Register, we obtained information on filling of prescriptions for osteoporosis drugs (bisphosphonates, calcium/vitamin D combinations, and selective estrogen receptor modulators) from July to October 2005, osteoporotic fractures from 1998 to 2004, and educational level for 645,429 people aged 75–89 years. Multivariate logistic regression analysis was used to investigate whether education was associated with use of osteoporosis drug therapy.


Higher education was associated with use of osteoporosis drugs for both men [odds ratio (OR)high education vs low, 1.27; 95% confidence interval (CI), 1.19–1.35] and women (ORhigh education vs low, 1.57; 95% CI, 1.52–1.61), after adjustment for age, osteoporotic fractures, and comorbidity (i.e., number of other drugs). Among those who had sustained a fracture (n = 57,613), the educational differences in osteoporosis drug treatment were more pronounced in women than men. Further, women were more likely to receive osteoporosis drug treatment after osteoporotic fracture.


Uptake of osteoporosis drug therapy seems to be unequally distributed in the elderly population, even in a country with presumably equal access to health care.


Access to health care Drug therapy Osteoporosis Pharmacoepidemiology Socioeconomic position 



This study was supported by grants from the Swedish Council for Working Life and Social Research (2007–1947) and the Swedish Research Council (2007–5870).

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • J. W. Wastesson
    • 1
    Email author
  • G. Ringbäck Weitoft
    • 2
  • M. G. Parker
    • 1
  • K. Johnell
    • 1
  1. 1.Aging Research CenterKarolinska Institutet & Stockholm UniversityStockholmSweden
  2. 2.National Board of Health and WelfareStockholmSweden

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