NHC Key Lab. of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Public Health School, Fudan University, Shanghai, 200032, China.
Shanghai Synyi Medical Technology Co., Ltd, 5th Floor, 232 Liangjing Road, Shanghai, China.
Arch Osteoporos. 2020 Aug 20;15(1):134. doi: 10.1007/s11657-020-00798-1.
This study demonstrates a low anti-osteoporosis drug treatment rate (22.1% in women, 9.5% in men) after osteoporotic fracture in the real-world setting of Fujian, China. The primary medication was calcitonin. The suboptimal treatment was particularly critical among men, low-level hospitals, wrist/vertebral fracture, and the younger elderly patients.
The objective of this study was to investigate the prescription patterns and related influencing factors of anti-osteoporosis drug prescribing after osteoporotic fracture in Fujian, China, between 2010 and 2016.
This is a retrospective cohort study based on an existing electronic health record database (National Healthcare Big Data in Fuzhou, China, 37 hospitals included). Patients over 50 years old with newly diagnosed osteoporotic fractures between 2010 and 2016 were included. Postfracture osteoporosis therapies were summarized by overall and fracture site. Multivariate logistic regression was performed to identify influencing factors of anti-osteoporosis medication (AOM) prescription.
Overall, 22.1% of women and 9.5% of men over 50 years old received AOM treatment after osteoporotic fracture within 1 year during 2010-2016, with particular low use of bisphosphonates, 5.3% in women and 1.5% in men. The highest rate of AOM treatment was found in patients with hip fracture (24.5%), followed by vertebral fracture (14.2%) and wrist fracture (2.3%). Of the AOM-treated patients, 90.5% received calcitonin therapy. The treatment rate of AOM showed a slight decline during 2010-2016, but steady rise trends were observed in Ca/vitamin D (VD) prescription. Hospital level, age, sex, previous osteoporosis, previous AOM prescription, and previous oral glucocorticoid prescription were strong predicting factors of AOM prescription.
In a real-world setting, AOM treatment was suboptimal and the treatment rate even decreased over time among osteoporosis fracture patients in Fujian, China. The suboptimal treatment was particularly critical among men, low-level hospitals, wrist/vertebral fracture, and the younger elderly patients.
本研究在中国福建的真实环境中展示了骨质疏松性骨折后低抗骨质疏松药物治疗率（女性 22.1%，男性 9.5%）。主要药物是降钙素。治疗不佳在男性、低级别医院、腕部/椎体骨折和年轻老年患者中尤为关键。
本研究旨在调查 2010 年至 2016 年期间中国福建骨质疏松性骨折后抗骨质疏松药物处方的模式和相关影响因素。
这是一项基于现有电子健康记录数据库（中国福州国家医疗保健大数据，包括 37 家医院）的回顾性队列研究。纳入年龄在 50 岁以上、2010 年至 2016 年新诊断为骨质疏松性骨折的患者。根据总体和骨折部位总结骨折后骨质疏松症治疗情况。采用多变量逻辑回归分析抗骨质疏松药物（AOM）处方的影响因素。
总体而言，2010-2016 年期间，50 岁以上女性骨质疏松性骨折后一年内接受 AOM 治疗的比例为 22.1%，男性为 9.5%，双膦酸盐的使用率尤其低，女性为 5.3%，男性为 1.5%。AOM 治疗率最高的是髋部骨折患者（24.5%），其次是椎体骨折（14.2%）和腕部骨折（2.3%）。在接受 AOM 治疗的患者中，90.5%接受了降钙素治疗。2010-2016 年期间，AOM 治疗率略有下降，但 Ca/维生素 D（VD）处方呈稳步上升趋势。医院级别、年龄、性别、既往骨质疏松症、既往 AOM 处方和既往口服糖皮质激素处方是 AOM 处方的强预测因素。
在中国福建的真实环境中，骨质疏松性骨折患者的 AOM 治疗并不理想，甚至随着时间的推移治疗率也有所下降。治疗不佳在男性、低级别医院、腕部/椎体骨折和年轻老年患者中尤为关键。
