Two-year persistence and compliance with osteoporosis therapies among postmenopausal women in a commercially insured population in the United States.
Two-year persistence and compliance with osteoporosis therapies among postmenopausal women in a commercially insured population in the United States.
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美国商业保险人群中绝经后妇女对骨质疏松症治疗的两年坚持和依从性。
DOI：
10.1007/s11657-017-0316-5
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发表时间：
2017-12
影响因子：
3
通讯作者：
Barron R
中科院分区：
文献类型：
--
作者：
Durden E;Pinto L;Lopez-Gonzalez L;Juneau P;Barron R
这项回顾性的观察性研究通过治疗、给药途径和给药频率评估了开始新的骨质疏松症治疗的绝经后妇女的2年持久性和依从性。与口服药物相比，接受注射药物的妇女的两年持久率和依从率更高。这项研究将先前的研究扩展到为期一年，通过在两年的时间内检验骨质疏松症治疗的持久性，并比较了美国拥有商业或医疗保险补充保险的绝经后妇女在持久性和遵从性方面的短期和长期趋势。这项回顾性的观察性队列研究纳入了2012年1月1日至12月31日(即指数日期)期间新开始骨质疏松症治疗的女性≥50岁，指数日期前14个月和指数日期后24个月连续参加≥。在两年的随访中评估持续性(无60天间隔的持续治疗)和对指数治疗的依从性。采用多变量Logistic回归方法比较不同治疗方案和给药方案的持久性和依从性。这项研究包括43,543名平均年龄(标准差)为65(10)岁的患者。在两年的随访中，接受注射药物治疗的患者(不包括每3个月注射一次)的持久性和依从性高于口服药物治疗的患者(从20%到31%)。此外，开始服用双磷酸盐(每天一次除外)、雷洛昔芬(每天一次)或唑来膦酸(每年一次)的患者与地诺舒单抗(每6个月一次)相比，持续治疗的几率显著降低。两年后，开始注射治疗的患者比开始口服治疗的患者有更大的持久性和依从性。与那些开始更频繁地(例如，每天和每周)口服或注射药物的患者相比，每6个月开始注射一次的患者的持久性显著更高。
This retrospective, observational study assessed 2-year persistence and compliance by treatment, route of administration, and dosing frequency in postmenopausal women initiating a new osteoporosis therapy. Two-year persistence and compliance rates were higher in women receiving injectables compared with oral agents. This study extends previous studies limited to 1-year follow-up by examining persistence with osteoporosis therapies over a 2-year period and compares short- and long-term trends in persistence and compliance among postmenopausal women with commercial or Medicare supplemental insurance in the USA. This retrospective, observational cohort study enrolled women ≥50 years newly initiating osteoporosis therapy between January 1 and December 31, 2012 (i.e., the index date), with continuous enrollment ≥14 months before and ≥24 months after their index date. Persistence (continuous therapy without a >60-day gap) and compliance with the index therapy were evaluated at 2 years of follow-up. Multivariable logistic regression was used to compare the odds of persistence and compliance across treatment and dosing regimens. This study included 43,543 patients with mean (standard deviation) age 65 (10) years. At 2 years of follow-up, persistence and compliance were higher for patients treated with injectable agents (ranging from 34 to 41%, excluding an every-3-month injection) than those treated with oral agents (ranging from 20 to 31%). Additionally, patients initiating oral bisphosphonates (except risedronate once daily), raloxifene (daily), or zoledronic acid (annually) had significantly lower odds of persistence compared with denosumab (every 6 months). Patients initiating injectable therapies had greater persistence and compliance at 2 years than those initiating oral therapies. Patients initiating an every-6-month injection had significantly higher persistence compared with those initiating more frequently dosed (e.g., daily and weekly) oral or injectable agents.