Treatment for Osteoporosis among Women in Japan: Associations with Patient Characteristics and Patient-Reported Outcomes in the 2008–2011 Japan National Health and Wellness Surveys
This study was conducted to identify characteristics associated with treatment for osteoporosis among women aged 50 years and older in Japan and to explore differences among patients according to treatment regimen. Data were provided by a large annual survey representative of Japanese aged 18 and older; all measures were by self-report. Women aged 50 and older who reported diagnosed osteoporosis () were compared based on current treatment status using bivariate statistics and logistic regression. Approximately 1 in 3 women in this study reporting diagnosed osteoporosis were currently untreated. Factors associated with current treatment for osteoporosis included having ≥1 physician visit in the prior 6 months (OR = 5.4, ), self-rated moderate or severe osteoporosis (OR = 2.8, ), completion of menopause (OR = 1.6, ), and family history of osteoporosis (OR = 1.5, ), while longer duration of osteoporosis diagnosis (OR = 0.9, ) and arthritis (OR = 0.7, ) were associated with lower odds of treatment. These findings suggest that diagnosed patients are not being actively managed in the longer term, and efforts need to be made to ensure that patients stay engaged with their healthcare providers. 1. Introduction Osteoporosis is characterized by low bone mass density (BMD) and increased likelihood of bone fracture [1]. Fracture sequelae include pain, stature changes, decreased independence, psychiatric distress, increased hospitalization, and increased morbidity and mortality [2, 3]. Population-based estimates indicate that greater than 15 million people are affected by osteoporosis in Japan, with billions ($US) spent in Japan for hospital care of fractures [4]. Epidemiological estimates of the annual incidence of osteoporosis in Japan are 0.6% for men and 2.3% for women aged 40–79 [1]. Fracture rates indicate the burden of the disease on society, with hip fracture incidence increasing 1.7-fold from 1987 to 1997. With incidence of osteoporotic hip fractures in Japan estimated at approximately 31,300 men and 116,800 women per year [5], the 10-year probability of hip fracture is greater in Japan than in China or Korea [6–8]. The reduction of BMD with age and after menopause makes women older than 50 years a particularly vulnerable group. Residual lifetime risk of hip fracture in those 50 years of age in the Tottori prefecture, Japan, was recently estimated at 5.6% for men but 20.0% for women [6]. Vertebral fracture risk is also high in Japanese women, at 59.7 per 1,000 person-years for women aged 60–69 and 141 per 1,000 person-years in women aged more than 80 years
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