Highlights
- •Access to anti-osteoporosis medication after hip fracture was found to be suboptimal in Korea.
- •One in three elderly patients with hip fracture received osteoporosis drug therapy.
- •Very old age, male sex, and comorbidity were risk factors for under-treatment.
- •Thiazolidinedione use was a predictive factor for hip fracture treatment in women.
Abstract
Purpose
This study aims to evaluate access to anti-osteoporosis medication (AOM) and the factors
affecting their prescription for Korean elderly patients with a hip fracture.
Methods
A cross-sectional study was conducted on hip fracture patients aged 65 years or more
using national-level data from 2013 to 2014. The prescription rates of AOM within
3 months after hip fracture were determined and the factors affecting AOM prescriptions
were identified through multivariate logistic regression.
Results
A total of 6307 elderly patients were selected from a national medical insurance database,
giving an estimated 15,768 patients nationally in a nine-month period. One-third of
the patients (33.5%) received an AOM prescription and only 9.4% of the patients were
prescribed an AOM with calcium and vitamin D supplements. Being 80 years and older
(adjusted OR, 0.78; 95% CI, 0.70–0.88) and having three or more comorbid diseases
(adjusted OR, 0.66; 95% CI, 0.55–0.78) were associated with a lower likelihood of
an AOM prescription. Female sex (adjusted OR, 2.54; 95% CI, 2.17–2.98), an osteoporosis
diagnosis (adjusted OR, 2.50; 95% CI, 2.15–2.91), concurrent thiazolidinedione therapy
(adjusted OR, 2.11; 95% CI, 1.29–3.45) and a dual-energy X-ray absorptiometry (DXA)
examination after hip fracture (adjusted OR 4.11; 95% CI, 3.67–4.62) were all significant
predictive factors for AOM prescription. Bisphosphonates were the most frequently
prescribed AOMs (92.2%).
Conclusions
The AOM prescription rate for elderly patients with hip fractures was suboptimal in
Korea. Factors affecting an AOM prescription were age, sex, clinical comorbidity,
osteoporosis status, concurrent thiazolidinedione therapy, and receiving a DXA examination
after hip fracture.
Abbreviations:
AOM (anti osteoporotic medications), IOF (International Osteoporosis Foundation), NOF (National Osteoporosis Foundation), HIRA-APS (Health Insurance Review and Assessment Service-Adult Patient Sample), HIRA (Health Insurance Review and Assessment Service), ICD (International Classification of Diseases), DXA (dual-energy X-ray absorptiometry), CCI (Charlson Comorbidity Index), SERM (selective estrogen receptor modulator), OR (odds ratio), CI (confidence interval), SD (standard deviation)Keywords
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Article info
Publication history
Published online: June 15, 2017
Accepted:
June 9,
2017
Received in revised form:
June 5,
2017
Received:
January 16,
2017
Identification
Copyright
© 2017 Published by Elsevier Ireland Ltd.
