Influence of patient training on persistence, compliance, and tolerability of different dosing frequency regimens of bisphosphonate therapy: An observational study in Turkish patients with postmenopausal osteoporosis

Abstract

ObjectiveIn our study, we aimed to evaluate the influence of training on compliance and persistence with bisphosphonate treatment given on a weekly vs. monthly basis in postmenopausal osteoporosis patients.MethodsA total of 979 patients with postmenopausal osteoporosis (mean age: 63.2 ± 7.2 years) were included in this national, multicenter, prospective non-interventional observational cohort registry study. Patients were randomized into training (n = 492, 50.3%, mean age: 63.4 ± 7.2 years) and control (n = 487, 49.7%, mean age: 63.0 ± 7.1 years) groups. Patients in each intervention group were given weekly (44.9% and 44.6% for training and control subjects, respectively) or monthly (55.1% and 55.4%, respectively) bisphosphonate regimens. After the initial visit, patients were followed up at three-month intervals throughout 12 months of treatment for evaluation of persistence, compliance and adverse events.ResultsOn average, 79.4% of the patients were persistent with the treatment with a mean of 350.4 days of duration during the 12-month follow-up period. The mean compliance in the compliant and fully compliant group remained at an average of 86.6%. No significant difference was detected between the training and control groups in terms of compliance and persistence. Significantly longer persistence (360.0 ± 89.0 vs. 345.0 ± 108.0 days; p = 0.035), higher percentage of persistent patients (83.4% vs. 74.2%; p = 0.012) and higher compliance rates (88.8% vs. 83.3%; p = 0.002) were noted in monthly regimen patients in comparison to those given weekly regimen.ConclusionOur findings revealed remarkably high rates for persistence and compliance with bisphosphonate treatment in postmenopausal osteoporosis, with no impact of training on compliance and persistence rates. Longer persistence and better compliance rates were achieved with the monthly bisphosphonate regimen when compared to the weekly regimen.

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

“…However, the monthly dose was associated with a significantly higher compliance rate. Many studies, including ours, supported the fact that compliance with the monthly dose was higher than that for the weekly dose [ 21 , 26 , 27 , 31 ].…”

“…The comparison of weekly versus monthly doses also showed an improved MPR with extended dosing intervals, [ 26 , 27 ] but the difference was not large and was occasionally controversial. USA military data showed that the overall rates of compliant patients (the ratio of MPR ≥ 80%) on weekly and monthly doses were 42.2% and 45.7%, respectively, for 1 year [ 28 ].…”

Non-Adherence to Anti-Osteoporosis Medication: Factors Influencing and Strategies to Overcome It. A Narrative Review

“…The authors did not find significant differences between the training and control groups in terms of compliance and persistence. The patients on the monthly bisphosphonate regimen showed significantly longer persistence in comparison to patients on the weekly regimen [22].…”

“…Most of the studies evaluating adherence to and persistence in osteoporosis treatment are based on patient education, using different methods. The use of telephone calls, emails, and alarm clocks as a reminder to take medication as prescribed compared with the usual care pathways seems not to improve adherence and persistence [21][22][23][24][25].…”

Osteoporotic Fractures among Selective Estrogen Receptor Modulator Users in South Korea: Analysis Using National Claims Database

“…It was reported one-year compliance was lower than 25% in all osteoporosis therapies, leaving patients with higher risk for fractures and public health costs. [7] Among the antiresorptive osteoporosis drugs, there are numerus studies on compliance of BP, [8][9][10][11][12][13][14] whereas, there are relatively few studies on compliance of SERM. [3,15,16] The primary objective of this study was (1) to evaluate the compliance to SERM medication in postmenopausal women with osteoporosis; and (2) to determine the risk of osteoporotic fractures according to the compliance or other patient characteristics, using the Korean National Health Insurance (KNHI) claims database.…”