Shinichi Nakatoh1, Kenji Fujimori2, Shigeyuki Ishii3, Junko Tamaki4, Nobukazu Okimoto5, Sumito Ogawa6, Masayuki Iki7. 1. Department of Orthopedic Surgery, Asahi General Hospital, 477, Tomari, Asahimachi, Shimo-Niikawa-gun, Toyama, 939-0741, Japan. nakato38@cosmo21.net. 2. Department of Health Administration and Policy, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan. 3. Department of Regulatory Science, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, Japan. 4. Department of Hygiene & Public Health, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, Japan. 5. Okimoto Clinic, 185-4, Kubi, Yutaka-machi, Kure City, Hiroshima, Japan. 6. Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan. 7. Department of Public Health, Kindai University Faculty of Medicine, 377-2, Oono-Higashi, Osaka Sayama City, Osaka, Japan.
Abstract
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. PURPOSE: 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. METHODS: 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. RESULTS: 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 (MPRdiscon) was 94.5%, and 92.7% of patients had an MPRdiscon ≥ 80%. The 2-year MPR (MPR730) was 61.9%, and 49.6% of patients had an MPR730 ≥ 80%. Both the persistence proportion and MPR730 were higher in females than in males, whereas MPRdiscon was higher in males. The persistence proportion and MPR730 were highest in the 70-79 years age group, whereas MPRdiscon improved with increasing age. The MPRdiscon and MPR730 were higher in the mixed-fracture and vertebral-fracture groups, respectively. The persistence proportion, MPRdiscon, and MPR730 were higher in patients with polypharmacy than in those without. CONCLUSION: 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.
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. PURPOSE: 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. METHODS: 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. RESULTS: 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 (MPRdiscon) was 94.5%, and 92.7% of patients had an MPRdiscon ≥ 80%. The 2-year MPR (MPR730) was 61.9%, and 49.6% of patients had an MPR730 ≥ 80%. Both the persistence proportion and MPR730 were higher in females than in males, whereas MPRdiscon was higher in males. The persistence proportion and MPR730 were highest in the 70-79 years age group, whereas MPRdiscon improved with increasing age. The MPRdiscon and MPR730 were higher in the mixed-fracture and vertebral-fracture groups, respectively. The persistence proportion, MPRdiscon, and MPR730 were higher in patients with polypharmacy than in those without. CONCLUSION: 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.
Authors: A Svedbom; F Borgstöm; E Hernlund; O Ström; V Alekna; M L Bianchi; P Clark; M D Curiel; H P Dimai; M Jürisson; R Kallikorm; M Lember; O Lesnyak; E McCloskey; K M Sanders; S Silverman; A Solodovnikov; M Tamulaitiene; T Thomas; N Toroptsova; A Uusküla; A N A Tosteson; B Jönsson; J A Kanis Journal: Osteoporos Int Date: 2017-12-11 Impact factor: 4.507
Authors: M R McClung; P Geusens; P D Miller; H Zippel; W G Bensen; C Roux; S Adami; I Fogelman; T Diamond; R Eastell; P J Meunier; J Y Reginster Journal: N Engl J Med Date: 2001-02-01 Impact factor: 91.245
Authors: D M Black; S R Cummings; D B Karpf; J A Cauley; D E Thompson; M C Nevitt; D C Bauer; H K Genant; W L Haskell; R Marcus; S M Ott; J C Torner; S A Quandt; T F Reiss; K E Ensrud Journal: Lancet Date: 1996-12-07 Impact factor: 79.321