Adherence to alendronate in male veterans
Adherence to alendronate in male veterans
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DOI：
10.1007/s00198-007-0471-4
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发表时间：
2008-03-01
影响因子：
4
通讯作者：
Elliott, M. E.
中科院分区：
文献类型：
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作者：
Hansen, K. E.;Swenson, E. D.;Elliott, M. E.
在退伍军人事务部的一家医疗中心，吸烟或报告有副作用的男性退伍军人更有可能出现阿仑膦酸钠不依从的情况，而在治疗期间接受骨密度测定的男性则不太可能出现阿仑膦酸钠不依从的情况。医疗服务提供者迫切需要提高骨质疏松症药物依从性的计划。初始方案应针对具有不依从性风险因素的患者。 简介 男性对骨质疏松症治疗的依从性尚不清楚。我们假设大约。一个中心 50% 的男性会坚持使用阿仑膦酸钠，并且一个或多个患者特定因素会与依从性相关。方法我们对男性退伍军人进行了一项回顾性图表审查研究，以确定两年内阿仑膦酸钠的依从率和预测因素。我们排除了女性、在其他地方接受初级保健的男性以及因低骨量以外的适应症服用阿仑膦酸钠的患者。我们将依从性定义为治疗前 24 个月的药物持有率 >= 80%。结果 治疗前 12 个月和 24 个月的依从性分别为 59% 和 54%。在多变量分析中，使用烟草的男性（OR 2.08，95% CI 1.13, 3.84，p=0.02）和报告副作用（OR 2.06，95% CI 1.14, 3.73，p=0.02）的男性不依从性的可能性更大，而在治疗期间接受骨密度治疗的男性中不依从性的可能性较小（OR 0.49，95% CI 0.26, 0.90, p=0.02)。 结论 对于吸烟或报告有副作用的男性退伍军人，阿仑膦酸钠不依从性的可能性更大，而在治疗期间进行骨密度测定的男性中，阿仑膦酸钠不依从性的可能性较小。医疗服务提供者迫切需要提高骨质疏松症药物依从性的计划。初始计划应针对具有不依从性风险因素的患者。
In one Veterans Affairs' medical center, alendronate non-adherence was more likely in male veterans who smoke or report side effects, and less likely in men undergoing bone densitometry during therapy. Providers urgently need programs to increase adherence to osteoporosis medications. Initial programs should target patients with risk factors for non-adherence.Introduction Adherence to osteoporosis therapy in men is unknown. We hypothesized that ca. 50% of men at one center would be adherent to alendronate and one or more patient-specific factors would associate with adherence.Methods We conducted a retrospective chart review study of male veterans to determine the rates and predictors of alendronate adherence over two years. We excluded women, men who received primary care elsewhere and those who took alendronate for indications other than low bone mass. We defined adherence as a medication possession ratio >= 80% in the first 24 months of therapy.Results Adherence in the first 12 and 24 months of therapy was 59% and 54%, respectively. In multivariate analyses, non-adherence was more likely in men using tobacco (OR 2.08, 95% CI 1.13, 3.84, p=0.02) and reporting side effects (OR 2.06, 95% CI 1.14, 3.73, p=0.02) and less likely in men undergoing bone density during therapy (OR 0.49, 95% CI 0.26, 0.90, p=0.02).Conclusions Alendronate non-adherence is more likely in male veterans who smoke or report side effects, and less likely in men having bone densitometry during therapy. Providers urgently need programs to increase adherence to osteoporosis medications. Initial programs should target patients with risk factors for non-adherence.