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01.12.2021 | Original Article

Insufficient persistence to pharmacotherapy in Japanese patients with osteoporosis: an analysis of the National Database of Health Insurance Claims and Specific Health Checkups in Japan

verfasst von: Shinichi Nakatoh, Kenji Fujimori, Shigeyuki Ishii, Junko Tamaki, Nobukazu Okimoto, Sumito Ogawa, Masayuki Iki

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2021

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Abstract

Summary

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 (MPR_discon) was 94.5%, and 92.7% of patients had an MPR_discon ≥ 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 MPR_discon was higher in males. The persistence proportion and MPR₇₃₀ were highest in the 70–79 years age group, whereas MPR_discon improved with increasing age. The MPR_discon and MPR₇₃₀ were higher in the mixed-fracture and vertebral-fracture groups, respectively. The persistence proportion, MPR_discon, 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.

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Titel: Insufficient persistence to pharmacotherapy in Japanese patients with osteoporosis: an analysis of the National Database of Health Insurance Claims and Specific Health Checkups in Japan
verfasst von: Shinichi Nakatoh
Kenji Fujimori
Shigeyuki Ishii
Junko Tamaki
Nobukazu Okimoto
Sumito Ogawa
Masayuki Iki
Publikationsdatum: 01.12.2021
Verlag: Springer London
Erschienen in: Archives of Osteoporosis / Ausgabe 1/2021
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-021-00993-8

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Insufficient persistence to pharmacotherapy in Japanese patients with osteoporosis: an analysis of the National Database of Health Insurance Claims and Specific Health Checkups in Japan

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