Coding and prescription rates of osteoporosis are low among distal radius fracture patients in Japan

  • Natsumi Saka
  • Kyoko Nomura
  • Hoichi Amano
  • Kenichi Fujimoto
  • Yoshinobu Watanabe
  • Hirotaka Kawano
  • Shinichi TaniharaEmail author
Original Article



This study aimed to clarify the coding and prescription rates for osteoporosis in distal radius fracture patients and to investigate the associated factors to help prevent subsequent osteoporotic fracture.

Materials and methods

Between 2014–2015, among 294,374 eligible individuals (42% female) aged 50–75 years in a health insurance claims database, we identified 192 individuals (mean age: 59.8 years, 74% female), counted the coding of distal radius fracture (International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) code: S525, S526), and determined if the patient had been assigned the code for osteoporosis and been prescribed osteoporosis medications. Logistic regression was performed to identify factors related to each rate.


The osteoporosis coding rate and osteoporosis medication prescription rate were 17.2% (n = 33) and 10.9% (n = 21), respectively. Most codes were assigned ≤ 3 months after injury (88%) at the distal radius fracture treatment facilities (84.8%). Patients who were assigned the code for osteoporosis or treated with osteoporosis medications were older (p = 0.08, p = 0.02, respectively), female (p = 0.05, p = 0.06, respectively) and having comorbidity (p = 0.02, p = 0.07, respectively). After adjustment, being female and having comorbidity remained the independent factors for the assignment of the code for osteoporosis (OR: 3.30, 95%, CI: 1.08–10.07, OR: 2.77, 95% CI: 1.24–6.12, respectively). No factor remained significant for the osteoporosis prescription. Active vitamin D analogues were most frequently prescribed medication (67%) followed by bisphosphonates (48%).


The overall coding and prescription rates for osteoporosis after distal radius fracture were low, which suggested that physician adherence to the osteoporosis guideline was low.


Adherence Distal radius fracture Fragility fracture Guideline ICD-10 coding 



This work was partly funded by the Research Project for the Analysis of the Utilization of Health Care Services and Estimation of the Number of Patients Based on the Patient Survey (H27-Statistics-Ippan-001) and by the Research Project for the Validity and Application of the Estimated Number of Patients Based on the Patient Survey (H29-Statistics-Ippan-003) from the Ministry of Health, Labor, and Welfare of Japan.

Author contributions

NS designed the study and wrote the initial draft of the manuscript. KN and TS contributed to analysis and interpretation of data and assisted in the preparation of the manuscript. All other authors contributed to data collection and interpretation and critically reviewed the manuscript. All authors approved the final version of the manuscript and agree to be accountable for all aspects of the work by ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.


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Copyright information

© The Japanese Society Bone and Mineral Research and Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Natsumi Saka
    • 1
  • Kyoko Nomura
    • 2
    • 3
  • Hoichi Amano
    • 3
    • 4
  • Kenichi Fujimoto
    • 3
  • Yoshinobu Watanabe
    • 1
  • Hirotaka Kawano
    • 1
  • Shinichi Tanihara
    • 3
    • 5
    Email author
  1. 1.Department of OrthopaedicsTeikyo University School of MedicineTokyoJapan
  2. 2.Department of Public HealthAkita University School of MedicineAkitaJapan
  3. 3.Graduate School of Public HealthTeikyo UniversityTokyoJapan
  4. 4.Department of Social and Behavioral SciencesHarvard. T.H. Chan School of Public HealthBostonUSA
  5. 5.Department of Public HealthKurume University School of MedicineKurumeJapan

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