Gastrointestinal symptoms and association with medication use patterns, adherence, treatment satisfaction, quality of life, and resource use in osteoporosis: baseline results of the MUSIC-OS study

Modi, Ankita; Sen, Shuvayu S.; Adachi, Jonathan D.; Adami, Silvano; Cortet, Bernard; Cooper, Alun; Geusens, Piet; Mellström, Dan; Weaver, Jerusha; Bergh, Joop van den; Nguyen, Allison Martin; Sajjan, Shiva

doi:10.1007/s00198-015-3388-3

Cited by 15 publications

(18 citation statements)

References 35 publications

(41 reference statements)

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“…However, discontinuation is not directly comparable to the medication-taking behaviors assessed by the ADEOS questionnaire. Such behaviors were assessed using ADEOS by the MUSIC OS study in Europe and Canada (MUSIC OS-EU), which found that treated osteoporosis patients with GI events had lower ADEOS scores than those without GI events (adjusted least squares mean difference −0.43; P < 0.001) [27]. This result is consistent with the findings of the MUSIC OS-AP study (adjusted least squares mean difference −0.348).…”

Section: Discussionsupporting

confidence: 66%

Impact of gastrointestinal events on patient-reported outcomes in Asia-Pacific women with osteoporosis: baseline results of the MUSIC OS-AP study

et al. 2017

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SummaryThe purpose of this study was to describe the impact of gastrointestinal events on patient-reported outcomes and health care resource use among Asia-Pacific women with postmenopausal osteoporosis. The results of this study show that gastrointestinal events decreased adherence, treatment satisfaction, and quality of life in Asia-Pacific women with postmenopausal osteoporosis.PurposeThis study aimed to describe the impact of gastrointestinal (GI) events on patient-reported outcomes and health care resource use among Asia-Pacific women with postmenopausal osteoporosis.MethodsThe MUSIC OS-AP study included an observational cohort study of postmenopausal women with osteoporosis. Women were classified as untreated or treated, with treated patients further classified as new or experienced users. Adherence was measured by the Adherence Evaluation of Osteoporosis treatment (ADEOS) questionnaire, treatment satisfaction by the Osteoporosis Patient Satisfaction Questionnaire (OPSAT) while general health-related and osteoporosis-specific quality of life were measured by the European Quality of Life-5 Dimensions (EQ-5D) questionnaire and the Osteoporosis Assessment Questionnaire (OPAQ), respectively. The association of GI events with these outcomes was determined by covariate-adjusted regression analysis of least squares mean differences in the scores of treated patients with and without GI events. Resource utilization was measured as the number of physician visits over the past 3 months, and multivariate regression analysis was used to assess the association of GI events with the likelihood of a visit.ResultsThe GI event profile, quality of life scores, and resource use were numerically similar in untreated and treated women. The rate of adherence among treated women was higher in experienced than in new users. As indicated by mean scores, experienced users had better quality of life and slightly higher treatment satisfaction and fewer physician visits than new users. Except for adherence in new users, all measures were similarly adversely affected by GI events in both new and experienced users.ConclusionsGI events decreased adherence, treatment satisfaction, and quality of life in Asia-Pacific women with postmenopausal osteoporosis.

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Section: Discussionsupporting

confidence: 66%

Impact of gastrointestinal events on patient-reported outcomes in Asia-Pacific women with osteoporosis: baseline results of the MUSIC OS-AP study

et al. 2017

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“…Our initial cohort of 24,571 patients (20,956 women [85.3%] and 3614 men [14.7%]; mean [SD] age = 84 [ years; 51% with moderate‐to‐severe cognitive impairment) included 18,869 bisphosphonate users and 5702 calcitonin users (Supplementary Figure S1). Before matching, bisphosphonate users were more likely to be younger, female, and nonwhite, and have received a dual‐energy X‐ray absorptiometry scan (Table ; Supplementary Table S4).…”

Section: Resultsmentioning

confidence: 88%

Effect of Bisphosphonates on Fracture Outcomes Among Frail Older Adults

Zullo

Zhang

Lee

et al. 2018

J American Geriatrics Society

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BACKGROUND Bisphosphonates are seldom used in frail, older adults, in part due to lack of direct evidence of efficacy in this population and increasing concerns about safety. OBJECTIVE We estimated the effects of bisphosphonates on hip fractures, nonvertebral fractures, and severe esophagitis among frail, older adults. DESIGN Population‐based retrospective cohort using 2008 to 2013 linked national Minimum Data Set assessments; Online Survey Certification and Reporting System records; and Medicare claims. SETTING US nursing homes (NHs). PARTICIPANTS Long‐stay NH residents 65 years and older without recent osteoporosis medication use (N = 24,571). Bisphosphonate initiators were 1:1 propensity score matched to calcitonin initiators (active comparator). MEASUREMENTS Hospitalized hip fracture, nonvertebral fracture, and esophagitis outcomes were measured using part A claims. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated, controlling for over 100 baseline characteristics. RESULTS The matched cohort included 5209 new bisphosphonate users and an equal number of calcitonin users (mean age [SD] = 85 [8] years; 87% female; 52% moderate‐severe cognitive impairment). Over a mean follow‐up of 2.5 (SD = 1.7) years, 568 residents (5.5%) had a hip fracture, 874 (8.4%) had a nonvertebral fracture, and 199 (1.9%) had a hospitalized esophagitis event. Users of bisphosphonates were less likely than calcitonin users to experience hip fracture (HR = 0.83; 95% CI = 0.71‐0.98), with an average gain in time without fracture of 28.4 days (95% CI = 6.0‐50.8 days). Bisphosphonate and calcitonin users had similar rates of nonvertebral fracture (HR = 0.91; 95% CI = 0.80‐1.03) and esophagitis events (HR = 1.11; 95% CI = 0.84‐1.47). The effects of bisphosphonates on fractures and esophagitis were generally homogeneous across subgroups, including those defined by age, sex, history of prior fracture, and baseline fracture risk. CONCLUSIONS Use of bisphosphonates is associated with a meaningful reduction in hip fracture among frail, older adults, but little difference in nonvertebral fracture or severe esophagitis. J Am Geriatr Soc 67:768–776, 2019.

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“…Of these, 2545 patients remained eligible for analysis at month 12 of whom 535 were new users and 2010 were experienced users. The baseline demographic and clinical characteristics of the study sample have been reported elsewhere [ 32 ]. Briefly, the mean age of the study population was 69.4 years, and about half the patients (49.4%) had a history of osteoporotic fracture.…”

Section: Resultsmentioning

confidence: 99%

Association of gastrointestinal events with quality of life and treatment satisfaction in osteoporosis patients: results from the Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study (MUSIC OS)

et al. 2017

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SummaryThe purpose of this study was to assess the association of GI events with HRQoL and treatment satisfaction. The effect of baseline GI events persisted through 1 year of follow-up, as indicated by lower EQ-5D, OPAQ-SV, and treatment satisfaction scores among patients with vs without baseline GI events. The presence of GI events is an independent predictor of decreased HRQoL and treatment satisfaction in patients being treated for osteoporosis.IntroductionThe goal of this study was to assess the association of gastrointestinal (GI) events with health-related quality of life (HRQoL) and treatment satisfaction in patients being treated for osteoporosis.MethodsMUSIC OS was a multinational, prospective, observational study examining the impact of GI events on osteoporosis management in postmenopausal women. In this analysis, HRQoL and treatment satisfaction were assessed at baseline, 6, and 12 months and compared between patients with and without GI events. Covariate-adjusted scores were calculated using multivariate least-squares regression analysis, and differences between the mean scores of patients with and without baseline and post-baseline GI events were determined.ResultsAmong the 2959 patients in the analysis, unadjusted scores at each time point were lower (i.e., worse) for patients with GI events than patients without GI events. In adjusted analyses, the effect of baseline GI events persisted through 1 year of follow-up, as indicated by lower EQ-5D and OPAQ-SV scores at 12 months among patients with vs without baseline GI events (−0.04 for the EQ-5D utility score, −5.07 for the EQ-5D visual analog scale, −3.35 for OPAQ physical function, −4.60 for OPAQ emotional status, and −8.50 for OPAQ back pain; P ≤ 0.001 for all values). Decrements in month 12 treatment satisfaction scores were −6.46 for patients with baseline GI events and −7.88 for patients with post-baseline GI events.ConclusionsThe presence of GI events is an independent predictor of decreased HRQoL and treatment satisfaction in patients being treated for osteoporosis.Electronic supplementary materialThe online version of this article (doi:10.1007/s00198-017-4116-y) contains supplementary material, which is available to authorized users.

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Gastrointestinal symptoms and association with medication use patterns, adherence, treatment satisfaction, quality of life, and resource use in osteoporosis: baseline results of the MUSIC-OS study

Cited by 15 publications

References 35 publications

Impact of gastrointestinal events on patient-reported outcomes in Asia-Pacific women with osteoporosis: baseline results of the MUSIC OS-AP study

Impact of gastrointestinal events on patient-reported outcomes in Asia-Pacific women with osteoporosis: baseline results of the MUSIC OS-AP study

Effect of Bisphosphonates on Fracture Outcomes Among Frail Older Adults

Association of gastrointestinal events with quality of life and treatment satisfaction in osteoporosis patients: results from the Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study (MUSIC OS)

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