Adherence and occurrence of fractures after switching to once-monthly oral bisphophonates.
Adherence and occurrence of fractures after switching to once-monthly oral bisphophonates.
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DOI：
10.1002/pds.2048
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发表时间：
2010-12
影响因子：
2.6
通讯作者：
Yood, Robert A.
中科院分区：
文献类型：
--
作者：
Briesacher, Becky A.;Andrade, Susan E.;Harrold, Leslie R.;Fouayzi, Hassan;Yood, Robert A.
减少药物的剂量需求通常会增加依从性，尽管这种关系尚未在每月一次口服双膦酸盐（BP）中得到证实。该研究的目的是测试从每周一次的BP转换为每月一次的BP是否可以改善依从性和骨折风险。这是2003-2007年全国行政卫生数据库中每周一次BP新用户的中断时间序列分析。参与者包括1835名转换为每月一次BP的人和两个倾向匹配的对照组：1835名转换为不同的每周一次BP的人，以及1835名没有转换的人。我们测量了转换前和转换后的充分依从性的变化，即每月药物拥有率>0.80，并计算了骨折的发病率比[IRR]。所有研究组在治疗的第一年都经历了严重的依从性失败：在每月一次转换者中，充分依从者的比例为42%，每周一次转换者中为47%，非转换者中为37%。然而，每月一次转换与较少的依从性失败相关（转换前每月依从性减少4%，转换后每月依从性减少1%，p<0.000）。其他组的依从率没有统计学显著变化。我们没有检测到每月一次转换的骨折风险显著降低：转换后1年，每月一次转换者相对于每周一次转换者的骨折发生率风险比为IRR 0.83，95% CI：0.50-1.36，相对于非转换者的IRR 0.90，95% CI：0.54-1.49。将口服双膦酸盐的剂量需求从每周一次减少到每月一次，降低了依从性失败，但对骨折风险的影响不确定。
Reducing dosing demands of medications generally increases adherence, although this relationship has not been demonstrated with the once-monthly oral bisphosphonates (BP). The study aim is to test whether switching from once-weekly BPs to once-monthly BPs improves adherence and fracture risk. This is an interrupted times-series analysis of new users of once-weekly BPs in a nationwide administrative health database from 2003–2007. Participants include 1835 individuals who switched to once-monthly BPs and two propensity-matched comparator groups: 1835 individuals who switched to a different once-weekly BP, and 1835 who did not switch. We measured changes in adequate adherence pre- and post-switch as monthly medication possession ratio >0.80, and calculated incidence rate ratios [IRR] of osteoporotic fractures. All study groups experienced major adherence failure in the first year of therapy: the proportion of adequate adherers was 42% among once-monthly switchers, 47% among once-weekly switchers, and 37% among nonswitchers. However, the once-monthly switch was associated with less adherence failure (4% fewer adherers per month pre-switch vs. 1% fewer adherers per month post-switch, p<.000). There was no statistically significant change in adherence rates for the other groups. We did not detect significantly reduced fracture risk with once-monthly switch: 1 year post-switch, the fracture incidence risk ratios for once-monthly switchers relative to once-weekly switchers were IRR 0.83, 95% CI: 0.50–1.36, and IRR 0.90, 95% CI: 0.54–1.49, relative to nonswitchers). Reducing the dosing demands of oral bisphosphonates from once-weekly to once-monthly decreased adherence failure but had an uncertain impact on fracture risk.
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影响因子：
6.2
作者：
Patel, S;Kwan, JTC;Barron, J
通讯作者：
Barron, J
影响因子：
7.2
作者：
Andrade, SE;Gurwitz, JH;Platt, R
通讯作者：
Platt, R
DOI：
10.1111/j.1742-1241.2006.01059.x
发表时间：
2006-08-01
影响因子：
2.6
作者：
Cooper, A.;Drake, J.;Brankin, E.
通讯作者：
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影响因子：
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作者：
Yood, Robert A.;Mazor, Kathleen M.;Kahler, Kristijan H.
通讯作者：
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影响因子：
8.9
作者：
Recker, RR;Gallagher, R;MacCosbe, PE
通讯作者：
MacCosbe, PE