Department of Orthopedic Surgery, Asahi General Hospital, 477, Tomari, Asahimachi, Shimo-Niikawa-gun, Toyama, 939-0798, Japan.
Department of Health Administration and Policy, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
J Bone Miner Metab. 2021 May;39(3):501-509. doi: 10.1007/s00774-020-01188-w. Epub 2021 Jan 5.
Only a few large-scale studies have examined the care gap in Japan. The aim of this study was to investigate the persistence of and adherence to osteoporosis pharmacotherapy in Japan.
The rates of continuation (persistence) of and adherence to osteoporosis pharmacotherapy were investigated using medical insurance data, issued from July 2013 to December 2018, from the medical care system for elderly individuals in Hokkaido, Japan.
The study included 7918 male and 52,585 female patients. Persistence rates were 62.1% in the first year and 45.3% in the second year. There were 33,096 patients who discontinued medication; 8296 patients resumed medication during the observation period of 730 days. The median time to the discontinuation of medication for all the patients was 702 days. The 2-year medication possession ratio (MPR) was 63.8%; 30,989 patients (51.2%) had an MPR ≥ 80% and 20,788 (34.4%) had an MPR < 50%. Both the persistence and adherence were better in females than in males and worsened with increasing age. Comparisons of fracture history showed that persistence and MPR were higher in the no hip or vertebral fracture group, followed by hip fracture, vertebral fracture, and hip and vertebral fracture groups. Meanwhile, more patients in the hip fracture group had an MPR ≥ 80%.
Persistence of and adherence to osteoporotic pharmacotherapy are not very high in Japan. To bridge the care gap following osteoporosis pharmacotherapy, improvements are required for males, the elderly, and those with a history of vertebral fracture.
仅有少数几项大规模研究调查了日本的护理差距。本研究旨在调查日本骨质疏松症药物治疗的持续性和依从性。
使用 2013 年 7 月至 2018 年 12 月期间从日本北海道老年人医疗保健系统中获得的医疗保险数据，调查骨质疏松症药物治疗的持续（持久性）和依从性。
该研究包括 7918 名男性和 52585 名女性患者。第一年的持续性率为 62.1%，第二年为 45.3%。有 33096 名患者停止用药；在 730 天的观察期内，有 8296 名患者恢复用药。所有患者停药的中位时间为 702 天。所有患者的 2 年药物占有率（MPR）为 63.8%；30989 名患者（51.2%）的 MPR≥80%，20788 名患者（34.4%）的 MPR<50%。女性的持久性和依从性均优于男性，且随年龄增长而恶化。骨折史的比较表明，无髋部或椎体骨折组的持续性和 MPR 较高，其次是髋部骨折组、椎体骨折组和髋部及椎体骨折组。同时，髋部骨折组有更多的患者 MPR≥80%。
日本骨质疏松症药物治疗的持续性和依从性不是很高。为了弥合骨质疏松症药物治疗后的护理差距，需要改善男性、老年人和椎体骨折患者的情况。
