期刊论文详细信息
BMC Musculoskeletal Disorders
Adherence to osteoporosis regimens among men and analysis of risk factors of poor compliance: a 2-year analytical review
Tien-Tsai Cheng1  Ben Yu-Jih Su1  Shan-Fu Yu1  Ming-Chun Kuo2  Chun-Kai Chiu3 
[1] Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No 123, Ta-Pei Road, Niaosung, Kaohsiung 833, Taiwan;Division of Endocrinology & Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan;Division of Rheumatology, Allergy and Immunology, E-DA Hospital, I-Shou University, 1 ,Yi-Da Road, Jiau-shu Tsuen, Yan-chau Shiang, Kaohsiung, Taiwan
关键词: Persistence;    Compliance;    Osteoporosis regimens;    Adherence;   
Others  :  1129656
DOI  :  10.1186/1471-2474-14-276
 received in 2013-03-29, accepted in 2013-09-17,  发布年份 2013
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【 摘 要 】

Background

To investigate adherence and patient-specific factors associated with poor compliance with osteoporosis regimens among men.

Methods

In this retrospective chart review study, we collected data on male patients with osteoporosis treated in accordance with therapeutic recommendations. Adherence was determined by the compliance and persistence of those patients who had been dispensed an osteoporosis regimen after an index prescription. All osteoporosis regimens were considered equivalent for the purpose of investigating adherence.

Results

The prescriptions of 333 males met the inclusion criteria for data collection. The mean age was 68.6 ± 10.4 years. The median medication possession ratio (MPR, %) at years 1 and 2 was 90.1% (interquartile range (IQR) 19–100) and 53.7% (IQR 10.4-100), respectively; 52.3% of male patients at year 1 and 37.5% at year 2 had good compliance (defined as a MPR≧80%). The 1- and 2-year persistence rates were 45.9% and 30.0%, respectively. Patient-specific factors associated with poor compliance (MPR < 80%) during year 1 were first prescriptions given by orthopedists (odds ratio (OR) = 2.67; 95% confidence interval (CI) = 1.58-4.53; adjusted OR = 2.30, 95% CI = 1.26-4.22, p = 0.007). Male patients with rheumatoid arthritis (RA) (OR = 0.22, 95% CI = 0.06-0.78, adjusted OR = 0.19, 95% CI = 0.04-0.81, p = 0.025) and baseline bone mineral density (BMD) measurements (OR = 0.52, 95% CI = 0.32-0.85; adjusted OR = 0.51; 95% CI = 0.28-0.93, p = 0.029) were less likely to have poor compliance.

Conclusions

Adherence to osteoporosis regimens in males was suboptimal in our study. Poor compliance was more likely in prescription of the first anti-osteoporotic regimen by an orthopedist. Men with RA and BMD measurements before therapy had a lower risk of non-adherence. Healthcare professionals need to target patients with specific factors to improve adherence to osteoporotic regimens.

【 授权许可】

   
2013 Chiu et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Cole ZA, Dennison EM, Cooper C: Osteoporosis epidemiology update. Curr Rheumatol Rep 2008, 10(2):92-96.
  • [2]Johnell O, Kanis J, Gullberg G: Mortality, morbidity, and assessment of fracture risk in male osteoporosis. Calcif Tissue Int 2001, 69(4):182-184.
  • [3]Cree MW, Juby AG, Carriere KC: Mortality and morbidity associated with osteoporosis drug treatment following hip fracture. Osteoporos Int 2003, 14(9):722-727.
  • [4]Mnif H, Koubaa M, Zrig M, Trabelsi R, Abid A: Elderly patient's mortality and morbidity following trochanteric fracture. A prospective study of 100 cases. Orthop Traumatol Surg Res 2009, 95(7):505-510.
  • [5]Watts NB: Osteoporosis in Men. Endocr Pract 2013, 11:1-16.
  • [6]Romagnoli E, Del Fiacco R, Russo S, Piemonte S, Fidanza F, Colapietro F, Diacinti D, Cipriani C, Minisola S: Secondary osteoporosis in men and women: clinical challenge of an unresolved issue. J Rheumatol 2011, 38(8):1671-1679.
  • [7]Yang NP, Deng CY, Chou YJ, Chen PQ, Lin CH, Chou P, Chang HJ: Estimated prevalence of osteoporosis from a Nationwide Health Insurance database in Taiwan. Health Policy 2006, 75(3):329-337.
  • [8]Pande I, Scott DL, O'Neill TW, Pritchard C, Woolf AD, Davis MJ: Quality of life, morbidity, and mortality after low trauma hip fracture in men. Ann Rheum Dis 2006, 65(1):87-92.
  • [9]Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA: Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 1999, 353(9156):878-882.
  • [10]Gennari L, Bilezikian JP: Osteoporosis in men. Endocrinol Metab Clin North Am 2007, 36(2):399-419.
  • [11]Eichner SF, Lloyd KB, Timpe EM: Comparing therapies for postmenopausal osteoporosis prevention and treatment. Ann Pharmacother 2003, 37(5):711-724.
  • [12]Geusens PP, Roux CH, Reid DM, Lems WF, Adami S, Adachi JD, Sambrook PN, Saag KG, Lane NE, Hochberg MC: Drug Insight: choosing a drug treatment strategy for women with osteoporosis-an evidence–based clinical perspective. Nat Clin Pract Rheumatol 2008, 4(5):240-248.
  • [13]Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ: Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc 2007, 82(12):1493-1501.
  • [14]Hansen KE, Swenson ED, Baltz B, Schuna AA, Jones AN, Elliott ME: Adherence to alendronate in male veterans. Osteoporos Int 2008, 19(3):349-356.
  • [15]Cevikoi A, Umay E, Polat S, Ecerkale O, Cakci A: The relationship between bisphosphonate use and demographic characteristics of male osteoporosis patients. Clinics (Sao Paulo) 2011, 66(4):579-582.
  • [16]Lekkerkerker F, Kanis JA, Alsayed N, Bouvenot G, Burlet N, Cahall D, Chines A, Delmas P, Dreiser RL, Ethgen D, et al.: Adherence to treatment of osteoporosis: a need for study. Osteoporos Int 2007, 18(10):1311-1317.
  • [17]Gold DT, Alexander IM, Ettinger MP: How can osteoporosis patients benefit more from their therapy? Adherence issues with bisphosphonate therapy. Ann Pharmacother 2006, 40(6):1143-1150.
  • [18]Briesacher BA, Andrade SE, Fouayzi H, Chan KA: Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy 2008, 28(4):437-443.
  • [19]Ensrud KE, Barrett-Connor EL, Schwartz A, Santora AC, Bauer DC, Suryawanshi S, Feldstein A, Haskell WL, Hochberg MC, Torner JC, et al.: Randomized trial of effect of alendronate continuation versus discontinuation in women with low BMD: results from the Fracture Intervention Trial long-term extension. J Bone Miner Res 2004, 19(8):1259-1269.
  • [20]Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, Satterfield S, Wallace RB, Bauer DC, Palermo L, et al.: Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA 2006, 296(24):2927-2938.
  • [21]Netelenbos JC, Geusens PP, Ypma G, Buijs SJ: Adherence and profile of non-persistence in patients treated for osteoporosis–a large-scale, long-term retrospective study in The Netherlands. Osteoporos Int 2011, 22(5):1537-1546.
  • [22]Cotté FE, Fardellone P, Mercier F, Gaudin AF, Roux C: Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis. Osteoporos In 2010, 21(1):145-155.
  • [23]Dawson-Hughes B, Lindsay R, Khosla S, Melton L, Tosteson A, Favus M: Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington DC: National Osteoporosis Foundation; 2008.
  • [24]American College of Rheumatology Ad Hoc Committee on Glucocorticoid-Induced Osteoporosis: Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis: 2001 update. Arthritis Rheum 2001, 44(7):1496-1503.
  • [25]Cramer JA, Roy A, Burrell A, Fairchild CJ, Fuldeore MJ, Ollendorf DA, Wong PK: Medication compliance and persistence: terminology and definitions. Value Health 2008, 11(1):44-47.
  • [26]Yu SF, Chou CL, Lai HM, Chen YC, Chiu CK, Kuo MC, Su YJ, Chen CJ, Cheng TT: Adherence to anti-osteoporotic regimens in a Southern Taiwanese population treated according to guidelines: a hospital-based study. Int J Rheum Dis 2012, 15(3):297-305.
  • [27]Weycker D, Macarios D, Edelsberg J, Oster G: Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int 2006, 17(11):1645-1652.
  • [28]Recker RR, Gallagher R, MacCosbe PE: Effect of dosing frequency on bisphosphonate medication adherence in a large longitudinal cohort of women. Mayo Clin Proc 2005, 80(7):856-861.
  • [29]Solomon DH, Avorn J, Katz JN, Finkelstein JS, Arnold M, Polinski JM, Brookhart MA: Compliance with osteoporosis medications. Arch Intern Med 2005, 165(20):2414-2419.
  • [30]Lin TC, Yang CY, Yang YH, Lin SJ: Alendronate adherence and its impact on hip-fracture risk in patients with established osteoporosis in Taiwan. Clin Pharmacol Ther 2011, 90(1):109-116.
  • [31]Landfeldt E, Strom O, Robbins S, Borgstrom F: Adherence to treatment of primary osteoporosis and its association to fractures–the Swedish Adherence Register Analysis (SARA). Osteoporos Int 2012, 23(2):433-443.
  • [32]Downey TW, Foltz SH, Boccuzzi SJ, Omar MA, Kahler KH: Adherence and persistence associated with the pharmacologic treatment of osteoporosis in a managed care setting. South Med J 2006, 99(6):570-575.
  • [33]Clowes JA, Peel NF, Eastell R: The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomized controlled trial. J Clin Endocrinol Metab 2004, 89(3):1117-1123.
  • [34]Yood RA, Emani S, Reed JI, Lewis BE, Charpentier M, Lydick E: Compliance with pharmacologic therapy for osteoporosis. Osteoporos Int 2003, 14(12):965-968.
  • [35]Soong YK, Tsai KS, Huang HY, Yang RS, Chen JF, Wu PC, Huang KE: Risk of refracture associated with compliance and persistence with bisphosphonate therapy in Taiwan. Osteoporos Int 2013, 24(2):511-521.
  • [36]McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J: Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas 2004, 48(3):271-287.
  • [37]Boonen S, Kay R, Cooper C, Haentjens P, Vanderschueren D, Callewaert F, Milisen K, Ferrari S: Osteoporosis management: a perspective based on bisphosphonate data from randomised clinical trials and observational databases. Int J Clin Pract 2009, 63(12):1792-1804.
  • [38]Lo JC, Pressman AR, Omar MA, Ettinger B: Persistence with weekly alendronate therapy among postmenopausal women. Osteoporos Int 2006, 17(6):922-928.
  • [39]Gold DT, Silverman S: Review of adherence to medications for the treatment of osteoporosis. Curr Osteoporos Rep 2006, 4(1):21-27.
  • [40]Carnevale V, Nieddu L, Romagnoli E, Bona E, Piemonte S, Scillitani A, Minisola S: Osteoporosis intervention in ambulatory patients with previous hip fracture: a multicentric, nationwide Italian survey. Osteoporos Int 2006, 17(3):478-483.
  • [41]Devold HM, Furu K, Skurtveit S, Tverdal A, Falch JA, Sogaard AJ: Influence of socioeconomic factors on the adherence of alendronate treatment in incident users in Norway. Pharmacoepidemiol Drug Saf 2012, 21(3):297-304.
  • [42]Rossini M, Bianchi G, Di Munno O, Giannini S, Minisola S, Sinigaglia L, Adami S: Determinants of adherence to osteoporosis treatment in clinical practice. Osteoporos Int 2006, 17(6):914-921.
  • [43]Grossman Z, Silverman BG, Miron D: Physician specialty is associated with adherence to treatment guidelines for acute otitis media in children. Acta Paediatr 2013, 102(1):e29-33.
  • [44]Ideguchi H, Ohno S, Hattori H, Ishigatsubo Y: Persistence with bisphosphonate therapy including treatment courses with multiple sequential bisphosphonates in the real world. Osteoporos Int 2007, 18(10):1421-1427.
  • [45]Curtis JR, Westfall AO, Allison JJ, Becker A, Casebeer L, Freeman A, Spettell CM, Weissman NW, Wilke S, Saag KG: Longitudinal patterns in the prevention of osteoporosis in glucocorticoid-treated patients. Arthritis Rheum 2005, 52(8):2485-2494.
  • [46]Pickney CS, Arnason JA: Correlation between patient recall of bone densitometry results and subsequent treatment adherence. Osteoporos Int 2005, 16(9):1156-1160.
  • [47]Richards JS, Cannon GW, Hayden CL, Amdur RL, Lazaro D, Mikuls TR, Reimold AM, Caplan L, Johnson DS, Schwab P, et al.: Adherence with bisphosphonate therapy in us veterans with rheumatoid arthritis. Arthritis Care Res (Hoboken) 2012, 64(12):1864-1870.
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