Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Kadoorie Centre, University of Oxford, Oxford, UK.
Oxford University Hospitals NHS Foundation Trust, Trauma Research, Kadoorie Centre, John Radcliffe Hospital, Oxford, UK.
Bone Joint J. 2019 Nov;101-B(11):1402-1407. doi: 10.1302/0301-620X.101B11.BJJ-2019-0387.R1.
Bone health assessment and the prescription of medication for secondary fracture prevention have become an integral part of the acute management of patients with hip fracture. However, there is little evidence regarding compliance with prescription guidelines and subsequent adherence to medication in this patient group.
The World Hip Trauma Evaluation (WHiTE) is a multicentre, prospective cohort of hip fracture patients in NHS hospitals in England and Wales. Patients aged 60 years and older who received operative treatment for a hip fracture were eligible for inclusion in WHiTE. The prescription of bone protection medications was recorded from participants' discharge summaries, and participant-reported use of bone protection medications was recorded at 120 days following surgery.
Of 5456 recruited patients with baseline data, 2853 patients (52%) were prescribed bone protection medication at discharge, of which oral bisphosphonates were the most common, 4109 patients (75%) were prescribed vitamin D or calcium, and 606 patients (11%) were not prescribed anything. Of those prescribed a bone protection medication, only 932 patients (33%) reported still taking their medication 120 days later.
These data provide a reference for current prescription and adherence rates. Adherence with oral medication remains poor in patients with hip fracture. Cite this article: 2019;101-B:1402-1407.
骨健康评估和药物处方用于预防继发性骨折已成为髋部骨折患者急性治疗的一个组成部分。然而,对于该患者群体,关于处方指南的遵守情况和随后对药物的依从性,证据很少。
世界髋部创伤评估(WHiTE)是一项在英格兰和威尔士 NHS 医院进行的多中心、前瞻性髋部骨折患者队列研究。年龄在 60 岁及以上、接受手术治疗髋部骨折的患者有资格入选 WHiTE。从参与者的出院小结中记录骨保护药物的处方情况,在手术后 120 天记录参与者报告的骨保护药物使用情况。
在纳入的 5456 名有基线数据的患者中,2853 名患者(52%)在出院时开具了骨保护药物,其中最常见的是口服双膦酸盐,4109 名患者(75%)开具了维生素 D 或钙,606 名患者(11%)未开具任何药物。在开具骨保护药物的患者中,只有 932 名患者(33%)报告在 120 天后仍在服用药物。
这些数据为当前的处方和依从率提供了参考。髋部骨折患者口服药物的依从性仍然很差。