Top

Archives of Osteoporosis

Published in:

Open Access 01-12-2023 | Bisphosphonate | Original Article

A real-world study of treatment patterns among patients with osteoporotic fracture: analysis of a Japanese hospital database

Authors: Hiroshi Hagino, Yoko Yoshinaga, Etsuro Hamaya, Tzu-Chieh Lin, Mayank Ajmera, Juliana Meyers

Published in: Archives of Osteoporosis | Issue 1/2023

Abstract

Summary

Health records of patients hospitalized for osteoporotic fracture were analyzed. Prior to the index hospital admission, most patients were not receiving any antiosteoporotic treatment. During the index hospitalization visit, 25.5% of patients received antiosteoporotic treatment. The most common treatment regimens were active vitamin D₃, bisphosphonates, and teriparatide.

Purpose

To examine the real-world treatment patterns and factors associated with receipt of treatment among Japanese patients with osteoporotic fracture.

Methods

We retrospectively analyzed health records of patients who were hospitalized for osteoporotic fracture between February 2016 and February 2018 in Japan. The type and duration of treatment with antiosteoporotic medications prescribed during hospital stays and after discharge were examined using descriptive statistics. Demographic and clinical factors (e.g., age, previous diagnoses, Charlson Comorbidity Index scores) associated with osteoporotic treatment were explored using multivariable logistic regression.

Results

A total of 112,275 patient medical records were evaluated, including 56,574 records from patients with hip fracture, 26,681 records from patients with vertebrae fracture, and 29,020 patients with non-vertebral non-hip fractures. Prior to the index hospital admission, most patients (91.7%, n = 102,919) were not receiving any antiosteoporotic treatment. For those receiving treatment, active vitamin D₃ (51.1%, n = 4778) and bisphosphonates (47.5%, n = 4441) were the most common. During the index hospitalization visit, 25.5% (n = 28,678) of patients received treatment for their fracture, including active vitamin D₃ (n = 17,074), bisphosphonates (n = 10,007), and teriparatide (n = 4561). Upon discharge, 41.5% (n = 46,536) of patients returned to their home and 34.3% (n = 38,542) of patients were transferred to a different hospital or medical care facility. Variables associated with receipt of treatment at follow-up included older age, previous diagnoses of osteoporosis and fracture, and higher Charlson Comorbidity Index scores.

Conclusion

Despite osteoporotic fracture being a major health concern within older Japanese populations, treatment with antiosteoporotic medication regimens remains generally low.

Available only for authorised users

Iki M (2012) [Epidemiology of osteoporosis in Japan]. Clin Calcium 22(6):797–803. http://dx.doi.org/CliCa1206797803

Fujiwara S, Kasagi F, Masunari N, Naito K, Suzuki G, Fukunaga M (2003) Fracture prediction from bone mineral density in Japanese men and women. J Bone Miner Res 18(8):1547–1553. https://doi.org/10.1359/jbmr.2003.18.8.1547 CrossRef

Hagino H (2021) Current and future burden of hip and vertebral fractures in Asia. Yonago Acta Med 64(2):147–54. https://doi.org/10.33160/yam.2021.05.001

Hagino H, Nakamura T, Fujiwara S, Oeki M, Okano T, Teshima R (2009) Sequential change in quality of life for patients with incident clinical fractures: a prospective study. Osteoporos Int 20(5):695–702. https://doi.org/10.1007/s00198-008-0761-5 CrossRef

Hosoi T (2015) [On “2015 Guidelines for prevention and treatment of osteoporosis.” Diagnostic criteria of primary osteoporosis and the criteria for pharmacological treatment]. Clin Calcium 25(9):1279–83. http://dx.doi.org/CliCa150912791283

Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90(1):14–21. https://doi.org/10.1007/s00223-011-9545-6 CrossRef

Sato M, Vietri J, Flynn JA, Fujiwara S (2014) Treatment for osteoporosis among women in Japan: associations with patient characteristics and patient-reported outcomes in the 2008–2011 Japan National Health and Wellness Surveys. J Osteoporos 2014:909153. https://doi.org/10.1155/2014/909153 CrossRef

Fujiwara S, Miyauchi A, Hamaya E, Nicholls RJ, Weston A, Baidya S et al (2018) Treatment patterns in patients with osteoporosis at high risk of fracture in Japan: retrospective chart review. Arch Osteoporos 13(1):34. https://doi.org/10.1007/s11657-018-0443-7 CrossRef

Fujihara N, Fujihara Y, Hamada S, Yoshida M, Tsukushi S (2021) Current practice patterns of osteoporosis treatment in cancer patients and effects of therapeutic interventions in a tertiary center. PLoS ONE 16(3):e0248188. https://doi.org/10.1371/journal.pone.0248188 CrossRef

10.

Medical Data Vision. About MDV Database (2021) https://en.mdv.co.jp/about-mdv-database/

11.

Sobue T, Fukuda H, Matsumoto T, Lee B, Ito S, Iwata S (2021) The background occurrence of selected clinical conditions prior to the start of an extensive national vaccination program in Japan. PLoS ONE 16(8):e0256379. https://doi.org/10.1371/journal.pone.0256379 CrossRef

12.

Tanaka S, Hagino H, Ishizuka A, Miyazaki T, Yamamoto T, Hosoi T (2016) Validation study of claims-based definitions of suspected atypical femoral fractures using clinical information. Jpn J Pharmacoepidemiol 21(1):13–19. https://doi.org/10.3820/jjpe.21.13 CrossRef

13.

Iihara N, Ohara E, Bando Y, Yoshida T, Ohara M, Kirino Y (2019) Fragility fractures in older people in Japan based on the National Health Insurance Claims Database. Biol Pharm Bull 42(5):778–785. https://doi.org/10.1248/bpb.b18-00974 CrossRef

14.

Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(Suppl 2):S3-7. https://doi.org/10.1007/s00198-004-1702-6 CrossRef

15.

Charlson ME, Charlson RE, Peterson JC, Marinopoulos SS, Briggs WM, Hollenberg JP (2008) The Charlson comorbidity index is adapted to predict costs of chronic disease in primary care patients. J Clin Epidemiol 61(12):1234–1240. https://doi.org/10.1016/j.jclinepi.2008.01.006 CrossRef

16.

Curtis JR, Cai Q, Wade SW, Stolshek BS, Adams JL, Balasubramanian A et al (2013) Osteoporosis medication adherence: physician perceptions vs. patients’ utilization. Bone 55(1):1–6. https://doi.org/10.1016/j.bone.2013.03.003 CrossRef

17.

Mikyas Y, Agodoa I, Yurgin N (2014) A systematic review of osteoporosis medication adherence and osteoporosis-related fracture costs in men. Appl Health Econ Health Policy 12(3):267–277. https://doi.org/10.1007/s40258-013-0078-1 CrossRef

18.

Nakatoh S, Fujimori K, Tamaki J, Okimoto N, Ogawa S, Iki M (2021) Insufficient persistence of and adherence to osteoporosis pharmacotherapy in Japan. J Bone Miner Metab 39(3):501–509. https://doi.org/10.1007/s00774-020-01188-w CrossRef

19.

Fujiwara S, Zhao X, Teoh C, Jaffe DH, Taguchi Y (2019) Disease burden of fractures among patients with osteoporosis in Japan: health-related quality of life, work productivity and activity impairment, healthcare resource utilization, and economic costs. J Bone Miner Metab 37(2):307–318. https://doi.org/10.1007/s00774-018-0916-1 CrossRef

20.

Solomon DH, Johnston SS, Boytsov NN, McMorrow D, Lane JM, Krohn KD (2014) Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. J Bone Miner Res 29(9):1929–37. https://doi.org/10.1002/jbmr.2202 CrossRef

21.

Kim SC, Kim MS, Sanfélix-Gimeno G, Song HJ, Liu J, Hurtado I et al (2015) Use of osteoporosis medications after hospitalization for hip fracture: a cross-national study. Am J Med 128(5):519–26.e1. https://doi.org/10.1016/j.amjmed.2015.01.014 CrossRef

22.

Kung AW, Fan T, Xu L, Xia WB, Park IH, Kim HS et al (2013) Factors influencing diagnosis and treatment of osteoporosis after a fragility fracture among postmenopausal women in Asian countries: a retrospective study. BMC Womens Health 13:7. https://doi.org/10.1186/1472-6874-13-7 CrossRef

23.

Klop C, Gibson-Smith D, Elders PJ, Welsing PM, Leufkens HG, Harvey NC et al (2015) Anti-osteoporosis drug prescribing after hip fracture in the UK: 2000–2010. Osteoporos Int 26(7):1919–1928. https://doi.org/10.1007/s00198-015-3098-x CrossRef

24.

Augustine AM, Shamrao D, Basnet S, Bhoja AN, Shareef J (2018) Study of drug utilization pattern of calcium, vitamin D supplements, and anti-osteoporosis drugs in patients with osteoporotic fracture: a prospective cross-sectional study. Asian J Pharm Clin Res 11(12):370–373 CrossRef

25.

Degli Esposti L, Girardi A, Saragoni S, Sella S, Andretta M, Rossini M et al (2019) Use of antiosteoporotic drugs and calcium/vitamin D in patients with fragility fractures: impact on re-fracture and mortality risk. Endocrine 64(2):367–377. https://doi.org/10.1007/s12020-018-1824-9 CrossRef

26.

Le Floch P, Kermarrec P, Gentric A (2019) Overwhelming underuse of bisphosphonates in French nursing home residents after proximal femoral fracture. J Nutr Health Aging 23(4):378–380. https://doi.org/10.1007/s12603-019-1169-y CrossRef

27.

Nakatoh S, Fujimori K, Ishii S, Tamaki J, Okimoto N, Ogawa S et al (2021) Insufficient increase in bone mineral density testing rates and pharmacotherapy after hip and vertebral fracture: analysis of the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Arch Osteoporos 16(1):130. https://doi.org/10.1007/s11657-021-00992-9 CrossRef

28.

Hiligsmann M, Cornelissen D, Vrijens B, Abrahamsen B, Al-Daghri N, Biver E et al (2019) Determinants, consequences and potential solutions to poor adherence to anti-osteoporosis treatment: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Osteoporosis Foundation (IOF). Osteoporos Int 30(11):2155–2165. https://doi.org/10.1007/s00198-019-05104-5 CrossRef

29.

Yu SF, Cheng JS, Chen YC, Chen JF, Hsu CY, Lai HM et al (2019) Adherence to anti-osteoporosis medication associated with lower mortality following hip fracture in older adults: a nationwide propensity score-matched cohort study. BMC Geriatr 19(1):290. https://doi.org/10.1186/s12877-019-1278-9 CrossRef

30.

Fujiwara S, Buchanan-Hughes A, Ng A, Page J, Adachi K, Li H (2022) Real-world evaluation of osteoporotic fractures using the Japan Medical Data Vision database. Osteoporos Int. https://doi.org/10.1007/s00198-022-06472-1 CrossRef

Title: A real-world study of treatment patterns among patients with osteoporotic fracture: analysis of a Japanese hospital database
Authors: Hiroshi Hagino
Yoko Yoshinaga
Etsuro Hamaya
Tzu-Chieh Lin
Mayank Ajmera
Juliana Meyers
Publication date: 01-12-2023
Publisher: Springer London
Keywords: Bisphosphonate
Osteoporosis
Osteoporosis
Published in: Archives of Osteoporosis / Issue 1/2023
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-022-01201-x

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

A real-world study of treatment patterns among patients with osteoporotic fracture: analysis of a Japanese hospital database

Abstract

Summary

Purpose

Methods

Results

Conclusion

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2023

Risk factors for the comorbidity of osteoporosis/osteopenia and kidney stones: a cross-sectional study

Characterization and effectiveness of a Fracture Liaison Services program in Colombia

Correction to: Epidemiology of fragility fracture of the pelvic ring: a regional population-based study in Northern Japan

Data-driven development of the nationwide hip fracture registry in the Netherlands

Zoledronic acid and denosumab for periprosthetic bone mineral density loss after joint arthroplasty: a systematic review and meta-analysis of randomized controlled trials

Osteoporosis-related appendicular fractures in Tikur Anbessa Specialized Hospital, Ethiopia: a prospective observational study