{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:01:11Z","timestamp":1790334071129,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100025520","name":"Medical Research Future Fund","doi-asserted-by":"publisher","award":["1137462"],"award-info":[{"award-number":["1137462"]}],"id":[{"id":"10.13039\/501100025520","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1108886"],"award-info":[{"award-number":["1108886"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000042","name":"Amgen Foundation","doi-asserted-by":"publisher","award":["BCGP\u201006"],"award-info":[{"award-number":["BCGP\u201006"]}],"id":[{"id":"10.13039\/100000042","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterise osteoporosis medicine prescribing patterns following low\u2010trauma fractures and identify predictors of early treatment initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Retrospective population\u2010based cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>New South Wales, Australia, using statewide linked administrative health data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults aged \u2265\u200950\u2009years with an incident low\u2010trauma fracture between January 2011 and June 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Primary outcomes were osteoporosis treatment prescribing patterns and timing of initiation after incident fracture over 3\u2009years, categorised as early (within 12\u2009months), late (within 1\u20133\u2009years) or no initiation. Secondary analyses examined predictors of time to treatment initiation within 12\u2009months using Fine\u2013Gray competing\u2010risk regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 132,268 individuals with incident fractures, 63.7% (84,222) were female. Overall, 29,802 (22.5%) initiated osteoporosis medicine, whereas 102,466 (77.5%) remained untreated. Among females (mean [standard deviation] age, 77.7 [10.1] years), 20.1% initiated therapy within 12\u2009months, 7.0% within 1\u20133\u2009years, and 72.9% remained untreated. Among males (mean [standard deviation] age, 77.2 [10.0] years), the corresponding proportions were 10.8%, 3.7% and 85.6%. After accounting for the competing risk of death, treatment initiation was more likely with non\u2010distal fractures, older age, polypharmacy, prior steroid use, prior dual\u2010energy x\u2010ray absorptiometry and later fracture year, and less likely with greater comorbidity, rural or regional residence and prior hospitalisation for falls. The strongest associations were for hip or vertebral fracture (subdistribution hazard ratio range, 1.90\u20133.03) and high comorbidity burden (subdistribution hazard ratio range, 0.72\u20130.75). Almost one in four late initiators had a refracture before starting treatment. Denosumab rapidly replaced oral bisphosphonates as the dominant therapy over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>More than three\u2010quarters of individuals remain untreated after fracture, highlighting persistent and substantial gaps in secondary fracture prevention. Treatment initiation is strongly associated with fracture site and multimorbidity burden, and initiation rates are lower in males. Increasing reliance on denosumab underscores the need for careful long\u2010term treatment planning and strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70285","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:11:09Z","timestamp":1788261069000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of Osteoporosis Treatment Initiation Following Low\u2010Trauma Fracture: A Population\u2010Based Retrospective Cohort Study in New South Wales, Australia, Using Linked Administrative Health Data"],"prefix":"10.5694","volume":"224","author":[{"given":"Mike","family":"Lin","sequence":"first","affiliation":[{"name":"Bone Epidemiology, Clinical and Translational Science Lab Garvan Institute of Medical Research  Sydney New South Wales Australia"},{"name":"St Vincent's Healthcare Clinical Campus, University of New South Wales  Sydney New South Wales 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