Visualisation of the unmet treatment need of osteoporotic fracture in Taiwan: A nationwide cohort study
Journal
International Journal of Clinical Practice
Journal Volume
72
Journal Issue
10
Date Issued
2018
Author(s)
Abstract
Aims: Recent clinical guidelines have suggested that patients experience an osteoporotic fracture should initiate anti-osteoporosis medications (AOMs). However, whether clinical guidelines translate well in “real-world” practices remain questioned. This study aimed to evaluate the “real-world” prescription pattern of AOMs and visualise the unmet treatment needs in different geographical areas in Taiwan. Methods: Using Taiwan's National Health Insurance Research Database, we identified patients diagnosed with a hip or vertebral fracture between 2009 and 2012. The treatment rate was defined as the proportion of patients receiving AOMs within 1 year after their index fracture. The qualitative geographical information systems approach was adopted to visualise the treatment needs of postfracture patients in different geographical areas. Results: Our study included 276,492 patients diagnosed with a hip or vertebral fracture between 2009 and 2012. The proportion of patients who received AOMs within 1 year after their index fracture increased with age and differed with fracture types and sex. For patients with hip fractures, the treatment rate ranged from 3.43% to 20.88% for female patients and from 0.69% to 10.04% for male patients in different age groups. For patients with vertebral fractures, the treatment rate ranged from 3.23% to 37.08% for female patients and from 1.85% to 23.05% for male patients. Cities in the mid-northern and southern areas of Taiwan had the highest unmet treatment need, with a treatment rate of less than 15%. Conclusion: The treatment rate of osteoporotic fractures with AOMs was diverse and suboptimal in Taiwan, especially among male patients. This study used a visualisation technique to display information about the treatment status in different geographical areas and help policymakers allocate resource appropriately. ? 2018 John Wiley & Sons Ltd
Other Subjects
bisphosphonic acid derivative; bone density conservation agent; adult; aged; Article; clinical practice; cohort analysis; controlled study; disease classification; female; fragility fracture; geographic distribution; geographic information system; health care need; health care survey; health care utilization; hip fracture; human; major clinical study; male; population research; practice guideline; prescription; priority journal; retrospective study; sex difference; spine fracture; Taiwan; very elderly; age; complication; factual database; fragility fracture; health service; hip fracture; middle aged; needs assessment; osteoporosis; public health; secondary prevention; sex factor; spatial analysis; spine fracture; statistics and numerical data; Taiwan; Adult; Age Factors; Aged; Aged, 80 and over; Bone Density Conservation Agents; Databases, Factual; Female; Geographic Information Systems; Health Services Needs and Demand; Hip Fractures; Humans; Male; Middle Aged; National Health Programs; Needs Assessment; Osteoporosis; Osteoporotic Fractures; Retrospective Studies; Secondary Prevention; Sex Factors; Spatial Analysis; Spinal Fractures; Taiwan
Publisher
Blackwell Publishing Ltd
Type
journal article