Prescription practices of anti-osteoporosis medication among Thai orthopedic surgeons (PAMOS study) in osteoporotic hip fracture.

Kittithamvongs P1, Pongpirul K2,3.

Arch Osteoporos. 2019 Jun 18;14(1):62. doi: 10.1007/s11657-019-0616-z.




As a medication for preventing osteoporotic fracture is recommended but scarcely prescribed, this study surveyed Thai orthopedic surgeons to explore key determinants of their prescription practices. In addition to a set of well-known determinants, the patient’s health insurance status could also influence the prescription practice.


Although many guidelines suggest using anti-osteoporosis medications in patients who suffered from fragility hip fractures, low rate of prescription was encountered all over the world. In this study, we aimed to explore potential determinants affecting the prescription of anti-osteoporosis medications by orthopedic surgeons.


Online questionnaire survey was conducted among randomly selected orthopedic surgeons in Thailand. We inquired the factors associated with anti-osteoporosis medication prescription (likely to prescribe, unlikely to prescribe, or not influential). The reasons for not prescribing were also inquired.


Two hundred and ninety-four participants responded to the questionnaires. Age, gender, previous fragility fracture, and BMD results seemed to influence the medication prescription. Interestingly, the type of reimbursement was responded as an important factor. The leading reason for not prescribing the medication was due to the high cost of the treatment.


Knowing the factors affecting the prescription of anti-osteoporosis medication is beneficial for strategic planning in order to increase the rate of prescription. The gap of treatment may be reduced, and the morbidity and mortality of the patients can be decreased.


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