Abstract
Only a few studies are available on the effect of the dosing interval of bisphosphonate on drug compliance. We analyzed the data of patients who were newly prescribed bisphosphonate using a national insurance claims database. Drug compliance was assessed by calculating medication possession ratio (MPR) over a minimum of a 1-year follow-up. This analysis included 281,996 new bisphosphonate users with a mean age of 68.9 years (92% women). The patients were divided into daily, weekly, monthly, 3-monthly, and switch groups (who changed the drug to other dosing intervals). The average MPR was the highest in the switch group (66%), and the longer the dosing interval, the higher the compliance (3-monthly, 56% vs. daily, 37%). “Non-compliant” was defined as an MPR under 80%. Various factors which were possibly associated with “non-compliant” MPR were investigated using multiple regression analysis. Multivariate analysis showed that male patients were more likely to be non-compliant with pharmacotherapy than female patients, with as odds ratio of 1.389. Younger patients had a significantly lower likelihood of being non-compliant than older patients for age 60–69 vs. age 80+. Long dosing intervals were recommended to improve compliance and special attention was given to older and male patients.
Highlights
Osteoporosis is common in postmenopausal women and the number of affected individuals is expected to increase gradually as the population continues to age [1]
Compliance with osteoporosis treatment is reported to be correlated with an improvement in bone mineral density (BMD) and the subsequent reduction in fracture risk [5]
This study examined the medication possession ratio (MPR) as an indirect marker of compliance with bisphosphonate therapy prescribed to large number of South Korean patients
Summary
Osteoporosis is common in postmenopausal women and the number of affected individuals is expected to increase gradually as the population continues to age [1]. Patients with osteoporosis are susceptible to pathologic fracture, and fracture-related costs are likely to increase by over USD 22 in the United States billion by 2025 [2]. Similar to hypertension and diabetes mellitus, there is no specific symptom of osteoporosis until pathologic fracture occurs. To reduce the risk of osteoporotic fracture, it might be important to make high-risk patients take appropriate drugs, as well as to continue drug therapy for a sufficient period. Compliance with osteoporosis treatment is reported to be correlated with an improvement in bone mineral density (BMD) and the subsequent reduction in fracture risk [5]. Other studies suggest that only half of the patients continue bisphosphonate therapy for 1 year, and 43% for 1 to
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