Factors affecting long-term compliance of osteoporotic patients with bisphosphonate treatment and QOL assessment in actual practice: alendronate and risedronate

Abstract

The aim of our study was to examine compliance with a daily dose of 5 mg alendronate (ALN) and 2.5 mg risedronate (RDN) in actual practice, and to determine the causes of noncompliance through a questionnaire. In addition, we studied the quality of life (QOL) of patients through another disease-related questionnaire. The overall compliance rate remained at approximately 40% one year after the initial dose. The rates did not differ significantly between the ALN group (783 patients) and the RDN group (491 patients). The compliances in the female group and the rheumatism group were better than in the male group and the nonrheumatism group. From the questionnaire, 36% of noncompliant patients showed adverse effects (AEs), and the other noncompliant patients stopped the medication in spite of having no AEs. A logistic regression analysis of factors that might have affected long-term compliance included AEs, an understanding of the disease, the method of ingestion, visiting medical facilities, the shape of the tablet, the cost of the drug, and the explanation of the doctor or pharmacist. This analysis showed that noncompliance occurred mainly due to AEs, the inconvenience of visiting a medical facility, unusual methods of ingestion, and a poor understanding of the disease. According to the results of the questionnaire for QOL assessment, the patients who continued the medication for more than 1 year had improved scores for pain in both the ALN and RDN groups. Osteoporotic treatment needs long-term patient compliance. To improve compliance, it is very important that doctors and pharmacists ensure that patients understand the purpose of this therapy.

Beneficial effect of risedronate on arterial thickening and stiffening with a reciprocal relationship to its effect on bone mass in female osteoporosis patients: A longitudinal study

“…One limitation of the present study is the lack of data on the effect of risedronate on ADL, since assessment of physical activity would have allowed evaluation of the significance of improvement of ADL, since improvement of pain by risedronate (Kamatari et al, 2007) might increase activities of daily living (ADL), which then might contribute in part to improvement of FN BMD and markers for atherosclerosis .…”

Compliance and persistence with osteoporosis therapies

“…Weycker et al [20] found that those who were compliant 90% or more of the time showed significantly reduced fracture risk (OR = 0.70, 95% CI, 0.52-0.93) than did those with an MPR less than 30. In the long term, poor compliance will lead to increased health care costs, because adverse events such as fractures are more likely [21,22]. McCombs et al [23] has shown that a decrease in fracture rates leads to reduced physician services, hospitalization services, and outpatient care, all of which lead to reduced health care costs.…”

The relationship between bisphosphonate use and demographic characteristics of male osteoporosis patients

“…15 Although this difference is attributed to the more advanced age of onset in males, the cause has not been fully elucidated. In a study by Kamatari et al, 16 which included 1274 patients with OP, it was reported that medication compliance in males was lower than in females; however, the cause of this noncompliance was not investigated in their study.…”