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Determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis.
Curr Med Res Opin. 2008 May; 24(5):1337-44.CM

Abstract

OBJECTIVE

To identify determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis. By considering the year of the introduction of weekly bisphosphonates important additional information is obtained.

METHODS

New female users of daily or weekly alendronate or risedronate between 1999 and 2004, aged >or= 45 years were identified from PHARMO RLS, including drug-dispensing and hospitalisation data of > 2 million residents of the Netherlands. One-year compliance with bisphosphonates was measured using the Medication Possession Ratio (MPR). To identify determinants of non-compliance, non-compliant women (MPR < 50%) were compared to compliant women (MPR >or= 80%). The effect of patient age, prescriber, initial dosing regimen, gastrointestinal adverse events, co-medication and fractures on non-compliance was investigated.

RESULTS

The study cohort included 8822 new users of bisphosphonates, of whom 5079 (58%) were compliant and 2720 (31%) were non-compliant after 1 year. Only 1023 women (11%) had a MPR between >or= 50% and < 80%. Daily dosing at start, increased number of co-medications and new use of intestinal agents in the year after starting bisphosphonates were independently associated with an increased odds of non-compliance. In contrast, higher age, first prescription from a specialist, osteoporosis related hospitalisation and use of NSAIDs in the year preceding bisphosphonate therapy decreased the odds of non-compliance.

CONCLUSION

This study revealed several determinants of non-compliance with bisphosphonates, the best controllable being the type of initial bisphosphonate, with daily dosing leading to more non-compliance than weekly dosing. However, compliance for both regimens is suboptimal, pointing to an unmet medical need.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Penning-van Beest FJ
PHARMO Institute, Utrecht, The Netherlands. fernie.penning@pharmo.nl
Erkens JA
No affiliation info available
Olson M
No affiliation info available
Herings RM
No affiliation info available

MeSH

AgedAlendronateAnalysis of VarianceBone DensityCohort StudiesDatabases, FactualDiphosphonatesDose-Response Relationship, DrugDrug Administration ScheduleEtidronic AcidFemaleHumansLogistic ModelsMiddle AgedNetherlandsOsteoporosis, PostmenopausalPatient ComplianceProbabilityPrognosisRetrospective StudiesRisedronic AcidRisk FactorsSeverity of Illness IndexTreatment OutcomeTreatment Refusal

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18380910

Citation

Penning-van Beest, Fernie J A., et al. "Determinants of Non-compliance With Bisphosphonates in Women With Postmenopausal Osteoporosis." Current Medical Research and Opinion, vol. 24, no. 5, 2008, pp. 1337-44.
Penning-van Beest FJ, Erkens JA, Olson M, et al. Determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis. Curr Med Res Opin. 2008;24(5):1337-44.
Penning-van Beest, F. J., Erkens, J. A., Olson, M., & Herings, R. M. (2008). Determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis. Current Medical Research and Opinion, 24(5), 1337-44. https://doi.org/10.1185/030079908X297358
Penning-van Beest FJ, et al. Determinants of Non-compliance With Bisphosphonates in Women With Postmenopausal Osteoporosis. Curr Med Res Opin. 2008;24(5):1337-44. PubMed PMID: 18380910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis. AU - Penning-van Beest,Fernie J A, AU - Erkens,Joëlle A, AU - Olson,M, AU - Herings,Ron M C, Y1 - 2008/03/31/ PY - 2008/4/3/pubmed PY - 2008/7/23/medline PY - 2008/4/3/entrez SP - 1337 EP - 44 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 24 IS - 5 N2 - OBJECTIVE: To identify determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis. By considering the year of the introduction of weekly bisphosphonates important additional information is obtained. METHODS: New female users of daily or weekly alendronate or risedronate between 1999 and 2004, aged >or= 45 years were identified from PHARMO RLS, including drug-dispensing and hospitalisation data of > 2 million residents of the Netherlands. One-year compliance with bisphosphonates was measured using the Medication Possession Ratio (MPR). To identify determinants of non-compliance, non-compliant women (MPR < 50%) were compared to compliant women (MPR >or= 80%). The effect of patient age, prescriber, initial dosing regimen, gastrointestinal adverse events, co-medication and fractures on non-compliance was investigated. RESULTS: The study cohort included 8822 new users of bisphosphonates, of whom 5079 (58%) were compliant and 2720 (31%) were non-compliant after 1 year. Only 1023 women (11%) had a MPR between >or= 50% and < 80%. Daily dosing at start, increased number of co-medications and new use of intestinal agents in the year after starting bisphosphonates were independently associated with an increased odds of non-compliance. In contrast, higher age, first prescription from a specialist, osteoporosis related hospitalisation and use of NSAIDs in the year preceding bisphosphonate therapy decreased the odds of non-compliance. CONCLUSION: This study revealed several determinants of non-compliance with bisphosphonates, the best controllable being the type of initial bisphosphonate, with daily dosing leading to more non-compliance than weekly dosing. However, compliance for both regimens is suboptimal, pointing to an unmet medical need. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/18380910/Determinants_of_non_compliance_with_bisphosphonates_in_women_with_postmenopausal_osteoporosis_ DB - PRIME DP - Unbound Medicine ER -