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Most women quickly stop taking bisphosphonates

Q Do women continue osteoporosis therapy for a meaningful period?

Synopsis

The authors of this analysis evaluated a very large drug database to determine the use patterns of patients who were prescribed drugs for osteoporosis. They evaluated adherence (the percentage of doses taken) and persistence (the use of continuous therapy) in 10,566 women.

The women (average age 64) were newly diagnosed with osteoporosis and had been started on a bisphosphonate and probably calcium/vitamin D, though these were not tracked in the database.

Eighty-five per cent of the women were placed on a weekly dosing regimen. Women quickly stopped taking the drug therapy, with only approximately 50 per cent of the women taking it after three months, and only one in five still taking the drug after one year. Accordingly, the women missed approximately 40 per cent of the doses they should have taken over the course of a year.

Monthly users were slightly more adherent than weekly users, although the results are still poor (63 per cent vs 54 per cent; P <0.05). Persistence and adherence did not vary among the three bisphosphonates.

These results are similar to those seen in other studies.

Level of evidence

1b (see www.infopoems.com/levels.html)

Reference

Downey TW et al. Adherence and persistence associated with the pharmacologic treatment of osteoporosis in a managed care setting. S Med J 2006;99:570-5.

Bottom line

Approximately half the women initially prescribed a bisphosphonate — daily or weekly treatment — will not be taking it after three months, and only one in five will be taking it after a year. Since this short duration is unlikely to provide them with meaningful benefit, the money spent on bone mineral density testing and the rest of the diagnostic work-up and follow-up (along with the cost of the initial drug therapy) is essentially wasted on four of five women diagnosed with osteoporosis.

This Patient Oriented Evidence that Matters (POEMs) is taken from InfoPOEMS/Inforetriever, a point of care evidence-based medicine tool, published by John Wiley. For more informatione-mail freynold@wiley.co.uk or visit www.infopoems.com

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