title: Prescription patterns of Chinese herbal products for patients with fractures in Taiwan: A nationwide population-based study.
abstract: BACKGROUND
  Traditional Chinese medicine (TCM) has been used in the treatment of fracture for thousands of years. However, large-scale surveys examing the utilization of Chinese herbal products (CHPs) for treating fractures and their related symptoms are lacking. This study aimed to investigate the prescription patterns of CHPs among patients with fractures in Taiwan.
  
  
  METHODS
  The TCM usage in patients with fractures was analyzed using a sample of one million individuals randomly selected from the National Health Insurance Research Database who were newly diagnosis with fractures in 2001-2008, with a followed-up period through 2010.
  
  
  RESULTS
  We identified 115,327 patients who were newly diagnosed with fractures in the study population. Among them, 4.97% (n=5731) adjunctively utilized TCM for fracture treatment. TCM users were mostly young or middle-aged, female, and resided in highly urbanized areas. With regard to the comorbidities of fractures, TCM users had a lower prevalence of coronary artery disease, chronic obstructive lung disease, diabetes mellitus, hypertension and stroke than non-TCM users, except for osteoporosis. Shu-jing-huo-xue-tang was the most frequently prescribed Chinese herbal formula, while Rhizoma Drynariae (Gu-sui-bu) was the most common single herb for patients with fractures. The CHPs were found to cover not only bone healing but also fracture-related symptoms. TCM users had lower medical expenditure for hospitalization for the first six months after incident fractures than non-TCM users (1749±2650 versus 2274±3159 US dollars, p<0.0001).
  
  
  CONCLUSIONS
  Our study identified the TCM utilization for patients with fractures in Taiwan. Integration of TCM treatment reduced the medical costs for hospitalization. Further basic research and clinical studies to investigate the mechanism and clinical efficacies of CHPs are warranted.
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Chinese Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
authors.forename: Hou-Hsun
authors.initials: HH
authors.lastname: Liao
authors.affiliation: School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan; Department of Chinese Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
authors.forename: Chia-Chou
authors.initials: CC
authors.lastname: Yeh
authors.affiliation: Health Data Management Office, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Che-Chen
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Chinese Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
authors.forename: Bor-Chyuan
authors.initials: BC
authors.lastname: Chen
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Chinese Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
authors.forename: Ming-Hsien
authors.initials: MH
authors.lastname: Yeh
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Kuo-Ming
authors.initials: KM
authors.lastname: Chang
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Mao-Feng
authors.initials: MF
authors.lastname: Sun
authors.affiliation: School of Chinese Medicine, China Medical University, Taichung, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hung-Rong
authors.initials: HR
authors.lastname: Yen
mesh_terms: D000328:Adult; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D050723:Fractures, Bone / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D008517:Phytotherapy; D010818:Practice Patterns, Physicians'; D013624:Taiwan; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Complementary and alternative medicine; Fracture; National health insurance research database; Rhizoma Drynariae; Shu-jing-huo-xue-tang; Traditional Chinese medicine