Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey
Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey
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DOI：
10.1007/s00198-006-0166-2
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发表时间：
2006-11-01
影响因子：
4
通讯作者：
Cooper, C.
中科院分区：
文献类型：
--
作者：
Carr, A. J.;Thompson, P. W.;Cooper, C.
目的探讨影响骨质疏松患者双膦酸盐治疗依从性和持久性的因素。设计横断面调查。设置英国全国调查。参与者是通过国家骨质疏松症协会以及报刊和广播广告招募的参与者包括533名50岁以上患有骨质疏松症的女性她们目前正在接受或在过去12个月内接受过双膦酸盐治疗。影响骨质疏松患者双膦酸盐治疗依从性和持久性的自我报告因素：骨折史、疼痛、服药的实际困难（给药频率、药物处理、对日常生活的影响）、对治疗的认知以及对双膦酸盐治疗的担忧。结果双膦酸盐治疗依从率为48%，与既往骨折相关[比值比（OR） 1.62, 95%可信区间（CI） 1.14-3.02]，对药物治疗的担忧（OR 1.49, 95% CI 1.01-2.20），对药物治疗的不满意程度较低（OR 0.65, 95% CI 0.44-0.97）。非持续性与对药物的不满意（风险比（HR） 1.83, 95% CI 1.38-2.43）、副作用（风险比（HR） 3.69, 95% CI 2.74-4.97）和对双膦酸盐治疗的担忧（风险比2.21,95% CI 1.48-3.30）相关。对于每日服用双磷酸盐（HR 1.53, 95% CI 1.1-2.33）和每周服用双磷酸盐（HR 1.90, 95% CI 1.17-3.07），服用双磷酸盐药物的实际困难-特别是过于频繁的给药-与非持久性相关。结论：自我报告的每日和每周双膦酸盐不依从性与停止治疗的决定无关（非持久性）。非持续性与副作用和其他因素有关，这些因素可以通过教育、信息和和谐的伙伴关系在临床实践中加以改变。
Objective To determine the factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis.Design Cross-sectional survey.Setting National survey in the UK.Participants Participants were recruited through the National Osteoporosis Society and advertisements in the press and on the radio and included 533 women over age 50 with osteoporosis who were currently taking or had taken bisphosphonate therapy within the previous 12 months.Main outcome measures Self-reported factors influencing adherence and persistence to bisphosphonate therapy in osteoporosis: fracture history, pain, practical difficulties taking medication (frequency of dosing, dealing with comedications, impact on daily routine), perceptions of therapy, and concerns about bisphosphonate therapy.Results Adherence to bisphosphonate therapy was 48% and was associated with previous fracture [odds ratio (OR) 1.62, 95% confidence interval (CI) 1.14-3.02], concerns about medication (OR 1.49, 95% CI 1.01-2.20), and less dissatisfaction with medication (OR 0.65, 95% CI 0.44-0.97). Nonpersistence was associated with dissatisfaction with medication (hazard ratio (HR) 1.83, 95% CI 1.38-2.43), side effects (HR 3.69, 95% CI 2.74-4.97), and concerns about bisphosphonate therapy (HR 2.21, 95% CI 1.48-3.30). For both daily (HR 1.53, 95% CI 1.1-2.33) and weekly bisphosphonates (HR 1.90, 95% CI 1.17-3.07), practical difficulties taking bisphosphonate medication-in particular, too frequent dosing-were associated with nonpersistence.Conclusions Self-reported nonadherence to daily and weekly bisphosphonates is independent of the decision to stop taking treatment (nonpersistence). Nonpersistence is associated with side effects and other factors that could be modified in clinical practice through education, information, and concordant partnerships.