Department of Orthopedic Surgery, Asahi General Hospital, 477, Tomari, Asahimachi, Shimo-Niikawa-gun, Toyama, 939-0741, Japan.
Department of Health Administration and Policy, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan.
Arch Osteoporos. 2021 Sep 13;16(1):131. doi: 10.1007/s11657-021-00993-8.
In Japan, persistence and the 2-year MPR were inadequate in increasing fracture control efficacy despite a high adherence rate during the treatment period. Both factors were higher in females and those with polypharmacy but worsened with increasing age.
Only a few large-scale studies have examined the care gap between the patients who need osteoporosis treatment and those who receive them in Japan. The aim of this study was to investigate the persistence and adherence to osteoporosis pharmacotherapy in Japan.
Continuation (persistence) rates and adherence to osteoporosis pharmacotherapy were investigated using medical insurance data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan, between April 2012 and March 2019.
The study included 528,806 male and 3,064,410 female patients. Persistence proportions were 56.6% in the first year and 46.3% in the second year. The medication possession ratio (MPR) from start to discontinuation of treatment (MPR) was 94.5%, and 92.7% of patients had an MPR ≥ 80%. The 2-year MPR (MPR) was 61.9%, and 49.6% of patients had an MPR ≥ 80%. Both the persistence proportion and MPR were higher in females than in males, whereas MPR was higher in males. The persistence proportion and MPR were highest in the 70-79 years age group, whereas MPR improved with increasing age. The MPR and MPR were higher in the mixed-fracture and vertebral-fracture groups, respectively. The persistence proportion, MPR, and MPR were higher in patients with polypharmacy than in those without.
In Japan, persistence and the 2-year MPR were inadequate in increasing fracture control efficacy despite a high adherence rate during the treatment period. To bridge the care gap following osteoporosis pharmacotherapy, improvements are required for males, the elderly, and those without polypharmacy.
尽管治疗期间的依从率很高，但在日本，持续性和两年 MPR 仍不足以提高骨折控制效果。这两个因素在女性和同时服用多种药物的患者中更高，但随年龄增长而恶化。
仅有少数大规模研究调查了日本需要骨质疏松治疗的患者和接受治疗的患者之间的护理差距。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。
使用日本国民健康保险索赔和特定健康检查全国数据库中的医疗保险数据，于 2012 年 4 月至 2019 年 3 月期间，调查骨质疏松症药物治疗的持续性和依从性。
研究包括 528806 名男性和 3064410 名女性患者。第一年的持续性比例为 56.6%，第二年为 46.3%。从开始治疗到停药的药物利用率（MPR）为 94.5%，92.7%的患者 MPR≥80%。两年 MPR（MPR）为 61.9%，49.6%的患者 MPR≥80%。女性的持续性比例和 MPR 均高于男性，而 MPR 则高于男性。70-79 岁年龄组的持续性比例和 MPR 最高，而 MPR 随年龄增长而提高。混合性骨折和椎骨骨折组的 MPR 较高。同时服用多种药物的患者的持续性比例、MPR 和 MPR 均高于未服用者。
在日本，尽管治疗期间的依从率很高，但持续性和两年 MPR 仍不足以提高骨折控制效果。为了缩小骨质疏松症药物治疗后的护理差距，需要提高男性、老年人和未服用多种药物患者的治疗效果。
