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J Bone Miner Metab. 2019 Jan;37(1):134-141. doi: 10.1007/s00774-018-0904-5. Epub 2018 Mar 13.

Gender differences in anti-osteoporosis drug treatment after osteoporotic fractures.

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Korea Institute for Health and Social Affairs, Sejong, Republic of Korea.
Gachon University Gil Medical Center, Incheon, South Korea.
Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, South Korea.
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea.
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Orthopaedic Surgery, Konkuk University Hospital, School of Medicine, Konkuk University, Seoul, South Korea.
Big Data Steering Department, National Health Insurance Service, Wonju, South Korea.
College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, 191 Hambakmoei-ro, Yeonsu-gu, Incheon, 21936, South Korea.


This study examined differences between men and women in factors affecting anti-osteoporosis drug treatment after osteoporotic fracture. Using a national claims database, we analyzed patients aged 50 years and older who experienced their first osteoporotic fracture between January 1, 2008, and December 31, 2012. We examined whether patients were prescribed anti-osteoporosis drugs within 6 months post-fracture. Factors associated with treatment status were identified using multivariate logistic regression. Among a total of 556,410 patients aged 50 and older, only 37% were prescribed anti-osteoporosis drugs within 6 months post-fracture. Female patients with fractures were more likely to receive pharmacotherapy than male patients (41.7 vs. 19.3%). Older age significantly increased the likelihood of receiving anti-osteoporosis drugs after osteoporotic fracture. For men, the adjusted odds ratio for receiving therapy was greatest in those aged 80 years and older (OR 6.4), and for women, it was largest in those aged 70-79 (OR 3.33). Both men and women were more likely to be prescribed drugs after a spine fracture, with men having significantly greater odds of receiving drug therapy (men, OR 7.1, 95% CI 6.5-7.9; women 4.79, CI 4.63-4.96). Patients with rheumatic disease or other osteoporosis-inducing comorbid disease were more likely to be prescribed anti-osteoporosis drugs. Our findings indicate that a lack of anti-osteoporosis pharmacotherapy after fracture remains a problem in Korea, especially among men, highlighting the need for effective quality improvement interventions to maximize post-fracture treatment rates.


Fractures; Gender differences; Osteoporosis; Pharmacotherapy; Post-fracture treatment

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