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    Adoption of once-monthly oral bisphosphonates and the impact on adherence

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    Authors
    Briesacher, Becky A.
    Andrade, Susan E.
    Harrold, Leslie R.
    Fouayzi, Hassan
    Yood, Robert A.
    UMass Chan Affiliations
    Department of Medicine, Division of Rheumatology
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2010-03-03
    Keywords
    Administration, Oral
    Aged
    Bone Resorption
    Diphosphonates
    Drug Administration Schedule
    Female
    Humans
    Male
    *Medication Adherence
    Middle Aged
    Patient Compliance
    Retrospective Studies
    Health Services Research
    Medicine and Health Sciences
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    Link to Full Text
    http://dx.doi.org/10.1016/j.amjmed.2009.05.017
    Abstract
    BACKGROUND: The extent of the adoption of once-monthly bisphosphonates into general clinical practice is not known, nor is it known if the novel formulation improves adherence. METHODS: We analyzed administrative claims 2003-2006 from a large employer-based health insurance database for incident use of oral bisphosphonates and stratified users by daily, weekly, and monthly dosing regimen. We measured adherence as the medication possession ratio (MPR) during the first year of therapy. We compared patient characteristics by dosing regimen and evaluated how the dosing regimen influenced the MPR. RESULTS: We identified 61,125 incident users of bisphosphonates (n=1034 daily, n=56,925 weekly, n=3166 monthly). Monthly bisphosphonate users were, on average, slightly older than the other groups (mean age 66 years for monthly users vs 65 years for weekly users or 66 years for daily users, P<.05) and more often lived in the North Central or South United States (76% vs 72% weekly users or 69% daily users, P<.05). There were no detectable differences among the dosing groups in the history of serious gastrointestinal risk, comorbidity burden, or prior osteoporotic fractures. During the first year of bisphosphonate therapy, 49% of monthly users had MPR> or =80% compared with 49% of weekly users (not significant) or 23% of daily users (P<.0001). CONCLUSION: We found little evidence of preferential prescribing of monthly bisphosphonates to certain types of patients. Furthermore, we found no evidence of improved bisphosphonate adherence with monthly dosing relative to weekly dosing, although adherence with either weekly or monthly dosing was significantly better than with daily dosing.
    Source
    Am J Med. 2010 Mar;123(3):275-80. Link to article on publisher's site
    DOI
    10.1016/j.amjmed.2009.05.017
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/36856
    PubMed ID
    20193837
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.amjmed.2009.05.017
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