Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data

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.

Novel formulations of oral bisphosphonates in the treatment of osteoporosis

“…Though these ranges are large, the authors did note that adherence and persistence were higher in formulations which required less frequent dosing and fracture rates were significantly lower in women with higher adherence (particularly a MPR > 80%) [45]. This finding is supported by data from national claims database which found that the MPR of bisphosphates rose with increasing interval between prescribed doses (from daily to 3 monthly), though some of the included medications were intravenously delivered [46].…”

Reducing Fracture Risk in Postmenopausal Osteoporosis: a Review of Effective and Safe Pharmacological Therapy Providing Adherence to Treatment

“…Авторы сделали выводы, что при приеме препаратов, требующих более редкого приема, частота переломов была значительно ниже, а приверженность терапии были существенно выше по сравнению с другими видами терапии [34]. Этот вывод подтверждается результатами анализа данных национальной медицинской базы, установившими, что ИПП БФ повышается по мере увеличения интервала между приемом препарата [35].…”