산부인과 의사에 의한 골다공증 치료제의 처방 양상
Prescription Patterns of Anti-osteoporosis Medications by Gynecologists
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연구목적: 건강보험심사평가원에서 발표한 2008년에 처방된 골다공증 관련 제제 자료를 바탕으로 산부인과 의사에 의한 처방 양상을 다른 진료과 의사의 처방 양상과 비교하고자 하였다. 연구재료 및 방법: 건강보험심사평가원에 등록된 처방 중 2008년도 골다공증 적응증만 있거나 골다공증과 골다공증 이외의 적응증이 있는 치료제가 처방된 처방전 5,895,905건 중에서 최종적으로 임의 추출된 603,870건 중에서 산부인과 의사에 의해 처방된 28,568건 (4.7%)만을 대상으로 분석하였다. 골다공증 적응증만 가진 치료제는 비스포스포네이트 혹은 비스포스포네이트 복합제, SERM, 주사 및 흡입용 칼시토닌, 비타민 K2, 이프리플라본 및 불소가 포함되었고, 골다공증 이외의 적응증이 있는 치료제로는 여성호르몬, 티볼론, 남성호르몬, 칼슘제, 칼슘-비타민 D 복합제, 비타민 D와 옥시메톨론이 포함되었다. 결과: 산부인과 의사의 골다공증 관련 제제의 처방 비중은 4.7%였고 산부인과 의사에 의한 골다공증 관련 처방 약제는 칼슘 및 비타민 D 제제가 60.7%로 가장 많이 처방되었고 티볼론을 포함한 여성호르몬이 44%로 처방되었으며 비스포스포네이트 및 비스포스포네이트 복합제가 27.5%, SERM이 3.56%를 차지하였다. 각 약제별 처방 중 산부인과 의사에 의한 처방 비중은 호르몬이 50.6%, 티볼론이 31.0%로 두 약제를 합하면 81.6%로 진료과 중에서 가장 높은 비중을 차지하였다. 골다공증 치료를 위한 치료제와 칼슘제 병용은 산부인과 의사에 의한 병용률이 34.1%로 모든 진료과목 중에 가장 높았다. 결론: 골다공증 관련 제제의 처방에 있어 산부인과 의사의 처방 비율은 매우 낮은 수준을 보이며 산부인과 의사의 경우 칼슘, 비타민 D 제제와 티볼론을 포함한 호르몬제의 처방률이 높았다.
Abstract
Objectives: To describe prescription patterns by gynecologists for osteoporosis therapy and to compare with the prescription patterns by physicians of other medical specialties based on the data from the Health Insurance Review and Assessment Service. Methods: A total of 28,568 prescription claims by gynecologists of 633,870 prescription claims by physicians with medications for osteoporosis alone or medications for other indications, including osteoporosis, were analyzed. The medications for osteoporosis alone were, selective estrogen receptor modulators (SERMs), calcitonin (injection or nasal spray), vitamin K2, ipriflavone, and fluoride. The medications for other indications including osteoporosis were estrogen, tibolone, testosterone, calcium, calcium-vitamin D complex, vitamin D, and oxymetholone. Results: Anti-osteoporosis medications were prescribed by 4.7% of gynecologists. Calcium and vitamin D were the most commonly prescribed medications by gynecologists (60.7%), followed by hormones, including tibolone (44%). Bisphosphonates, including bisphosphonate complex, were prescribed by 27.5% of gynecologists and SERMs were prescribed by 3.6% of gynecologists. Amongst all prescribers, the percentage of gynecologists was highest for hormones (50.6%), followed by tibolone (31.0%). When both medications were combined, the percentage of gynecologists among prescribers was 81.6%. The combination rate of calcium with other anti-osteoporosis medications was highest in gynecologists among prescribers of medical specialties (34.1%). Conclusion: A very small percentage of gynecologists prescribed anti-osteoporosis medications, while calcium, vitamin D, and hormones, including tibolone, were commonly prescribed by gynecologists.
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