Validation of the adherence evaluation of osteoporosis treatment (ADEOS) questionnaire for osteoporotic post-menopausal women

Abstract

SummaryWe developed and validated a specific 12-item questionnaire to evaluate adherence to oral antiresorptive medication by post-menopausal osteoporotic women in everyday practice. Over the following 9 months, an index of ≤16 was associated with an increase in the risk of treatment discontinuation of 1.69 and of 2.10 for new patients who had started treatment within the previous year.IntroductionAdherence to medication in osteoporosis is poor. The goal of this study was to develop and validate a disease-specific questionnaire to evaluate adherence to treatment of women with post-menopausal osteoporosis taking oral antiresorptive medication.MethodsA prototype adherence questionnaire with 45 items developed from patient interview, literature review, and physician opinion was evaluated in a sample of 350 post-menopausal women with osteoporosis treated in primary care. Item responses were matched against scores on the Morisky Medication Adherence Scale (MMAS). The most discriminant items were retained in the final questionnaire. Concurrent and predictive validity were assessed.ResultsTwelve items were associated with MMAS score at a probability level of 0.05. These were retained in the final questionnaire which provided an adherence index ranging from 0 to 22. An index of ≥20 was associated with a high probability of persistence and an index ≤ 16 with a high probability of treatment discontinuation in the following 9 months.ConclusionsThe ADEOS-12 is a simple patient-reported measure to determine adherence to osteoporosis treatments with good concurrent and discriminant validity. This is the first disease-specific adherence measure to have been developed for osteoporosis.Electronic supplementary materialThe online version of this article (doi:10.1007/s00198-011-1555-8) contains supplementary material, which is available to authorized users.

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

“…Among all experienced users (with and without GI symptoms), only 49.2 % had an ADEOS score ≥20, which is indicative of a high probability of medication persistence. Although ADEOS scores were not well correlated with adherence as measured by medication possession ratio (MPR) in the validation study [ 30 ], our results are within the range of adherence to osteoporosis therapy observed in administrative claims studies that calculated adherence as MPR. An MPR threshold of 0.80 is commonly used to distinguish between adherence and non-adherence; in the first year of therapy, typically 34–55 % of patients are adherent to pharmacological osteoporosis treatments [ 8 – 10 ].…”

“…Patients completed four instruments to assess treatment adherence, treatment satisfaction, and HRQoL. Adherence was assessed among experienced users with the 12-item adherence evaluation of osteoporosis (ADEOS) treatment questionnaire, which has been validated in women with osteoporosis [ 30 ]. Scores range from 0 to 22 with scores ≥20 predicative of a high probability of medication persistence.…”

Compliance and persistence with daily, weekly, and monthly bisphosphonates for osteoporosis in Japan: analysis of data from the CISA

“…Researchers have pointed out that detailed explanation to the patient about the fracture prevention effects, possible adverse drug reactions, and safety of BP therapy is more important than dosing interval in terms of ensuring persistence [ 21 – 24 ]. Persistence of BP therapy should be improved not only through prolonging the dosing interval but through individualizing the treatment to meet the patient’s preference and circumstance and thereby motivate him/her to continue treatment [ 25 – 27 ].…”

Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP): Design of a multinational, prospective, observational study examining the impact of gastrointestinal events on osteoporosis management in postmenopausal women

“…Patient-reported health care resource use was categorized as hospitalizations, fractures, surgeries, or visits to a general practitioner, specialist, or emergency department in the preceding 3–6 months. Medication adherence was measured by the Adherence Evaluation of Osteoporosis treatment (ADEOS) questionnaire (Breuil et al, 2012), and treatment satisfaction by the Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q) (Flood et al, 2006). Untreated participants did not complete the ADEOS or OPSAT-Q questionnaires.…”