Monthly or weekly bisphosphonate? Evaluation of satisfaction in patients with postmenopausal osteoporosis using OPSAT-Q questionnaire during the BOOSTER study in Croatia

Abstract

A prospective, open-labelled, multicentre 6-month study was designed to assess three categories that have high impact on Health-Related Quality of Life (HR-QoL). These categories were: satisfaction, preference and drug tolerability in postmenopausal patients with osteoporosis in Croatia, at first treated with weekly oral bisphosphonates, followed by monthly oral ibandronate. Three hundred eighty-five postmenopausal women who were treated with one of the weekly bisphosphonates for at least 6 months were included into the study and after they had signed written informed consent, the therapy was changed to monthly ibandronate. Satisfaction with the treatment was assessed with the Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q). Patients completed OPSAT-Q at the baseline visit before the change of therapy (visit 1) and 6 months after the change of therapy (visit 2). Following 6 months ibandronate therapy, the values in all four domains of the OPSAT-Q (convenience, confidence with daily activities, overall satisfaction, side effects) as well as in the Composite Satisfaction Score were higher in visit 2 (p < 0.001). Values in subjects enrolled into the patient assistance programme did not differ significantly from the values in subjects that were not (p = 0.399) except for the domain convenience (p = 0.026). This study demonstrates significantly higher satisfaction in patients who switched from the weekly bisphosphonate therapy regimen to monthly ibandronate in all observed aspects of treatment. Patients expressed preference for monthly bisphosphonate (ibandronate) in comparison with weekly bisphosphonates and found it to be a more convenient method of treatment. At the time of study, however, it was not known that the anti-fracture effect of ibandronate was smaller for hip fractures than with other bisphosphonates.

A Review of Patient Preferences for Osteoporosis Drug Treatment

“…In the clinical studies, the following questionnaires were used: Beliefs about Medicines Questionnaire (BMQ, including 22 questions in the following major domains: the necessity of the prescribed medication to manage osteoporosis now and in the future, concerns about the potential adverse effects of taking the prescribed medication, preference for one medication over the other) [ 24 , 25 ], Preference Satisfaction Questionnaire (PSQ, measuring preference, pill satisfaction, injection satisfaction, pill bother and injection bother) [ 25 – 28 ], questionnaires for preference adapted from Balto I and II [ 29 – 31 ], Osteoporosis Patient Satisfaction Questionnaire (OPSATQ) [ 26 , 32 ] and Treatment Satisfaction Questionnaire for Medication (TSQM; consisting of 14 items to assess an individual’s perception of effectiveness, side effects, convenience and global satisfaction) [ 33 ].…”

“…The open-label studies included patients who had been on weekly bisphosphonates and who were switched to a monthly regimen [ 26 , 32 , 35 ] or to another bisphosphonate or denosumab [ 33 ] and showed a preference for the less frequently administered treatment. Kendler et al (2011) found no difference in perceived necessity of osteoporosis treatment between 6-monthly injections or weekly oral bisphosphonates at baseline, but after 6 months, the perceived necessity was higher in the denosumab group.…”

Clinical Effects of a 6-Month Treatment Course of Ibandronate, Vitamin D, and Calcium in Postmenopausal Women from Central America: Results of a Multinational, Prospective Pilot Study

“…Another strength of our study was the evaluation of HRQoL by means of the mini-OQLQ. Effects of ibandronate on HRQoL have seldom been assessed [15,16]. Our results suggest that all aspects of QoL may improve with ibandronate, which should be a primary goal of antiresorptive therapy according to some authors [17].…”

Current situation of shared decision making in osteoporosis: A comprehensive literature review of patient decision aids and decision drivers

“…Several treatment characteristics that could influence the decision‐making process have been described in the literature: (1) route and frequency of administration 52 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ; (2) efficacy 52 , 57 , 58 , 60 , 61 , 65 , 67 , 69 , 71 , 73 ; (3) cost of treatment (for the patient and for society) 52 , 58 , 62 , 65 , 67 , 71 ; (4) adverse events or side effects 52 , 57 , 58 , 60 , 61 , 63 , 64 , 65 , 67 , 69 , 71 , 72 , 73 , 74 , 75 ; (5) total duration of the treatment 60 ; (6) convenience (i.e., number of pills, independency, dosing facility, body position) 57 , 63 , 64 ...…”