Prescription Patterns in Patients with Chronic Obstructive Pulmonary Disease and Osteoporosis
Received 13 November 2020
Accepted for publication 11 March 2021
Published 25 March 2021 Volume 2021:16 Pages 761—769
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Kuang-Ming Liao,1 Kai-Lin Chiu,2,3 Chung-Yu Chen2– 5
1Department of Internal Medicine, Chi Mei Medical Center, Chiali, Taiwan, Republic of China; 2Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China; 3Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China; 4Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, Republic of China; 5Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
Correspondence: Chung-Yu Chen
Kaohsiung Medical University, No. 100, Shiquan 1st Road, Sanmin District, Kaohsiung, 807, Taiwan, Republic of China
Email [email protected]
Objective: Patients with chronic obstructive pulmonary disease (COPD) have a higher risk of osteoporosis. Few studies have addressed the prescription patterns in osteoporosis patients with COPD. The purpose of this study was to conduct a retrospective study of the prescription patterns in patients with COPD and osteoporosis in Taiwan.
Methods: The study was conducted with data from the Taiwan National Health Insurance Research Database from January 1, 2003, to December 31, 2016. We selected the COPD population in Taiwan older than 40 years with at least one prescription for a bronchodilator. We excluded patients who had osteoporosis, fracture, asthma, or cancer before the diagnosis of COPD. After the diagnosis of COPD, patients who did not have osteoporosis were also excluded. We followed this COPD and osteoporosis cohort until they had been prescribed medication for osteoporosis.
Results: There were 13,407 patients with COPD and osteoporosis who received osteoporosis treatment. Among the patients who received treatment, the majority were female (n = 9136), accounting for 68.14% of all treated patients. A total of 53.4% of the patients had been prescribed steroids least once within the last year before receiving a diagnosis of osteoporosis. A total of 34.61% of the patients received systemic corticosteroids with a daily dose equivalent to 5 mg of prednisolone within the 3 months prior to the diagnosis of osteoporosis. The older the patient was, the higher the probability of the prescription of medication for osteoporosis. Patients with depression had a high probability of receiving medication for osteoporosis with adjusted hazard ratio of 1.141 (95% confidence interval, 1.072– 1.214).
Conclusion: The rate of prescriptions for the treatment of osteoporosis in patients with COPD was low. Physicians need to be aware of this issue and treat osteoporosis more aggressively in patients with COPD.
Keywords: chronic obstructive pulmonary disease, National Health Insurance Research Database, osteoporosis, prescription pattern
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