Determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis
Determinants of non-compliance with bisphosphonates in women with postmenopausal osteoporosis
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DOI：
10.1185/030079908x297358
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发表时间：
2008-05-01
影响因子：
2.3
通讯作者：
Herings, Ron M. C.
中科院分区：
文献类型：
--
作者：
Beest, Fernie J. A. Penning-van;Erkens, Joelle A.;Herings, Ron M. C.
Objective: To identify determinants of noncompliance 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 >= 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 >= 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 >= 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.
