Wang Chen-Yu, Fu Shau-Huai, Huang Chuan-Ching, Hung Chih-Chien, Yang Rong-Sen, Hsiao Fei-Yuan
School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Int J Clin Pract. 2018 Oct;72(10):e13246. doi: 10.1111/ijcp.13246. Epub 2018 Aug 24.
Recent clinical guidelines have suggested that patients experience an osteoporotic fracture should initiate anti-osteoporosis medications (AOMs). However, whether clinical guidelines translate well in "real-world" practices remain questioned. This study aimed to evaluate the "real-world" prescription pattern of AOMs and visualise the unmet treatment needs in different geographical areas in Taiwan.
Using Taiwan's National Health Insurance Research Database, we identified patients diagnosed with a hip or vertebral fracture between 2009 and 2012. The treatment rate was defined as the proportion of patients receiving AOMs within 1 year after their index fracture. The qualitative geographical information systems approach was adopted to visualise the treatment needs of postfracture patients in different geographical areas.
Our study included 276,492 patients diagnosed with a hip or vertebral fracture between 2009 and 2012. The proportion of patients who received AOMs within 1 year after their index fracture increased with age and differed with fracture types and sex. For patients with hip fractures, the treatment rate ranged from 3.43% to 20.88% for female patients and from 0.69% to 10.04% for male patients in different age groups. For patients with vertebral fractures, the treatment rate ranged from 3.23% to 37.08% for female patients and from 1.85% to 23.05% for male patients. Cities in the mid-northern and southern areas of Taiwan had the highest unmet treatment need, with a treatment rate of less than 15%.
The treatment rate of osteoporotic fractures with AOMs was diverse and suboptimal in Taiwan, especially among male patients. This study used a visualisation technique to display information about the treatment status in different geographical areas and help policymakers allocate resource appropriately.
近期临床指南建议，经历骨质疏松性骨折的患者应开始使用抗骨质疏松药物（AOM）。然而，临床指南在“现实世界”实践中的实际效果仍存疑问。本研究旨在评估AOM在“现实世界”中的处方模式，并可视化台湾不同地理区域未满足的治疗需求。
利用台湾全民健康保险研究数据库，我们确定了2009年至2012年间被诊断为髋部或椎体骨折的患者。治疗率定义为患者在首次骨折后1年内接受AOM治疗的比例。采用定性地理信息系统方法，可视化不同地理区域骨折后患者的治疗需求。
我们的研究纳入了2009年至2012年间被诊断为髋部或椎体骨折的276492名患者。首次骨折后1年内接受AOM治疗的患者比例随年龄增长而增加，且因骨折类型和性别而异。对于髋部骨折患者，不同年龄组的女性患者治疗率在3.43%至20.88%之间，男性患者在0.69%至10.04%之间。对于椎体骨折患者，女性患者治疗率在3.23%至37.08%之间，男性患者在1.85%至23.05%之间。台湾中北部和南部地区的城市未满足治疗需求最高，治疗率低于15%。
在台湾，AOM治疗骨质疏松性骨折的比例各异且未达最佳水平，尤其是男性患者。本研究使用可视化技术展示不同地理区域的治疗状况信息，有助于政策制定者合理分配资源。
