Predictive factors of non-treatment and non-persistence to osteoporosis medication after fragility hip fractures at 3 years after discharge: a multicentre, prospective cohort study in the northern Kyushu district of Japan

Masaya Kanahori, Yoshihiro Matsumoto, Toshifumi Fujiwara, Atsushi Kimura, Tomoko Tsutsui, Shinkichi Arisumi, Akiko Oyamada, Masanobu Ohishi, Ko Ikuta, Kuniyoshi Tsuchiya, Naohisa Tayama, Shinji Tomari, Hisaaki Miyahara, Takao Mae, Toshihiko Hara, Taichi Saito, Takeshi Arizono, Kozo Kaji, Taro Mawatari, Masami FujiwaraMinoru Takasaki, Kunichika Shin, Kenichi Ninomiya, Kazutoshi Nakaie, Antoku Yasuaki, Yukihide Iwamoto, Yasuharu Nakashima

Research output: Contribution to journalArticlepeer-review

Abstract

Summary: We examined osteoporosis medication use and factors affecting persistence in 497 patients with fragility hip fractures. Only 25.5% of patients received continuous medication for 3 years, and 44.1% of patients received no treatment. Low Barthel index at discharge was a risk factor for both non-treatment and non-persistence to osteoporosis medication. Purpose: Fragility hip fractures (FHF) caused by osteoporosis decrease the quality of life and worsen life expectancy. Use of osteoporosis medication may be an efficient method in the prevention of secondary FHF. However, previous studies have reported low rates of osteoporosis medication and persistence after FHF. This study aimed to evaluate osteoporosis medication use and factors affecting persistence in patients with FHF in the northern Kyushu area of Japan. Methods: A total of 497 FHF patients aged ≥ 60 years with a 3-year follow-up were included. We prospectively collected data from questionnaires sent every 6 months regarding compliance with osteoporosis medication. We compared baseline characteristics among three groups: no treatment (NT), no persistence (NP), and persistence (P), and conducted multivariable regression models to determine covariates associated with non-treatment (NT vs. NP/P) and non-persistence (NP vs. P). Results: There were 219 (44.1%), 151 (30.4%), and 127 (25.5%) patients in the NT, NP, and P groups, respectively. Factors associated with non-treatment were male sex, chronic kidney disease, no previous osteoporosis treatment, and low Barthel index (BI) at discharge. The only factor associated with non-persistence was a low BI at discharge. Factors associated with a low BI at discharge were male sex, older age, trochanteric fracture, and surgical delay. Conclusion: Low BI at discharge is a risk factor for both non-treatment and non-persistence to osteoporosis medication. Therefore, appropriate interventions to improve BI may result in persistence to osteoporosis medication.

Original languageEnglish
Article number132
JournalArchives of Osteoporosis
Volume16
Issue number1
DOIs
Publication statusPublished - Dec 2021

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

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