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Patients were included in the fragility fracture cohort if they (1) experienced a fracture of the hip, distal forearm or humerus between 5/1/2006 and 12/31/2009, (2) were continuously enrolled in fee-for-service Medicare Parts A and B for at least 36 months preceding the index fracture and at least 12 months following the fracture, (3) were alive and continuously enrolled in and used (one or more fill record) a stand-alone Medicare Part D plan for at least 6 months following the fracture, (4) did not have an identically-defined fragility fracture in the 36 months preceding the index fracture, (5) were predominantly community dwelling (not hospitalized for more than 90 days and had no prescriptions filled by a long-term care pharmacy type) in the first 6 months following index fracture, (6) had no cancer diagnosis (other than non-melanoma skin cancer), hospice enrollment, or managed Medicare enrollment at any time in claims records analyzed.
All medication use measures were based on Part D event fill records for the time frame specific to each cohort’s observation. The Lexi-Data Basic database (Lexicomp) was used to obtain the drug name, dose, brand or generic status, and active ingredient according to the National Drug Code (NDC).
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The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health
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