髋部骨折后的骨质疏松症护理：来自国民健康保险数据库和骨折联络服务的观察

Osteoporosis care after hip fracture: Observation from national health insurance database and fracture liaison services.

作者信息

Huang Chun-Feng, Lin Sheng-Chieh, Chen Ho-Min, Wu Chih-Hsing, Tu Shih-Te, Yang Rong-Sen, Huang Wei-Jia, Hwang Jawl-Shan, Chan Ding-Cheng

机构信息

Division of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan.

Department of Orthopedic Surgery, Chung Shan Medical University Hospital, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

出版信息

J Formos Med Assoc. 2023;122 Suppl 1:S74-S81. doi: 10.1016/j.jfma.2023.06.025. Epub 2023 Jul 12.

DOI:10.1016/j.jfma.2023.06.025

PMID:37451957

Abstract

BACKGROUND

The objective of this research was to report the trend of osteoporosis care after hip fractures from usual care (UC) and to compare the quality of care with those who received fracture liaison services (FLSs).

METHODS

Data on osteoporosis care for patients with hip fracture were acquired from the National Health Insurance claims (UC group), and surveys from FLS programs (FLS group). A total of 183,300 patients receiving UC and 3010 patients receiving FLS were studied. For the two groups, common osteoporosis care indicators, such as bone mineral density (BMD) testing rate, antiosteoporosis medication commencement rate, and adherence rate were described.

RESULTS

There were 2488 participants (82.7%) in the FLS group who completed Dual-energy X-ray absorptiometry (DXA) in 8 weeks, 155 (5.1%) who finished it between 8 weeks and 1 year. Even in 2018, when the DXA completion rate was at its highest, the completion rate in the UC group was only 23.5%. In terms of medication commencement, 2372 FLS patients (78.8%) received treatment within 3 months. Only 24.9% of the UC patients received antiosteoporosis medication within 3 months. Furthermore, antiosteoporosis medication adherence rate was 92.2% after 1 year and 83.9% after 2 years in the FLS group, but these were only 66.5% and 42.7%, respectively, in the UC group.

CONCLUSION

Patients who received FLS had more timely BMD exams, antiosteoporosis medication treatment, and higher adherence to antiosteoporosis therapy than those who received UC. The discrepancy in rates of continuing treatment became more significant over time between both groups.

摘要

背景

本研究的目的是报告髋部骨折后常规护理（UC）中骨质疏松症护理的趋势，并将护理质量与接受骨折联络服务（FLS）的患者进行比较。

方法

从国民健康保险索赔（UC组）中获取髋部骨折患者的骨质疏松症护理数据，并从FLS项目的调查中获取数据（FLS组）。共研究了183300名接受UC的患者和3010名接受FLS的患者。描述了两组常见的骨质疏松症护理指标，如骨密度（BMD）检测率、抗骨质疏松药物开始使用率和依从率。

结果

FLS组中有2488名参与者（82.7%）在8周内完成了双能X线吸收测定（DXA），155名（5.1%）在8周和1年之间完成。即使在2018年DXA完成率最高时，UC组的完成率也仅为23.5%。在药物开始使用方面，2372名FLS患者（78.8%）在3个月内接受了治疗。只有24.9%的UC患者在3个月内接受了抗骨质疏松药物治疗。此外，FLS组抗骨质疏松药物1年后的依从率为92.2%，2年后为83.9%，但UC组分别仅为66.5%和42.7%。