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

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

doi:10.1016/j.jfma.2023.06.025

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

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

Authors

Chun-Feng Huang¹, Sheng-Chieh Lin², Ho-Min Chen³, Chih-Hsing Wu⁴, Shih-Te Tu⁵, Rong-Sen Yang⁶, Wei-Jia Huang⁷, Jawl-Shan Hwang⁸, Ding-Cheng Chan⁹

Affiliations

¹ 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.
² Department of Orthopedic Surgery, Chung Shan Medical University Hospital, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
³ Health Data Research Center, National Taiwan University, Taipei, Taiwan.
⁴ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
⁶ Department of Orthopaedics, National Taiwan University Hospital, Taipei, Taiwan.
⁷ Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
⁸ Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁹ Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: doctord6226@yahoo.com.

PMID: 37451957
DOI: 10.1016/j.jfma.2023.06.025

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.

Keywords: Adherence; Fracture liaison service; Hip fracture; Osteoporosis.