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Influence on persistence and adherence with oral bisphosphonates on fracture rates in osteoporosis

  • Background and Aim: Oral bisphosphonates have been shown to reduce the risk of fractures in patients with osteoporosis. It can be assumed that the clinical effectiveness of oral bisphosphonates depends on persistence with therapy. Methods: The influence of persistence with and adherence to oral bisphosphonates on fracture risk in a real-life setting was investigated. Data from 4451 patients with a defi ned index prescription of bisphosphonates were included. Fracture rates within 180, 360, and 720 days after index prescription were compared between persistent and non-persistent patients. In an extended Cox regression model applying multiple event analysis, the influence of adherence was analyzed. Persistence was defined as the duration of continuous therapy; adherence was measured in terms of the medication possession ratio (MPR). Results: In patients with a fracture before index prescription, fracture rates were reduced by 29% (p = 0.025) comparing persistent and non-persistent patients within 180 days after the index prescription and by 45% (p < 0.001) within 360 days. The extended Cox regression model showed that good adherence (MPR ≥ 0.8) reduced fracture risk by about 39% (HR 0.61, 95% CI 0.47–0.78; p < 0.01). Conclusions: In patients with osteoporosis-related fractures, good persistence and adherence to oral bisphosphonates reduced fracture risk significantly.

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Author:Ariane Höer, Cornelia Seidlitz, Holger GotheORCiDGND, Guido Schiffhorst, Melvin Olson, Peyman Hadji, Bertram Häussler
DOI original:https://doi.org/10.2147/PPA.S4673
Parent Title (English):Patient Preference and Adherence
Document Type:Article
Year of Completion:2009
Publishing Institution:Hochschule Hannover
Release Date:2023/06/12
Tag:compliance; fracture risk; oral bisphosphonates; persistence
GND Keyword:Diphosphonate; Orales Arzneimittel; Persistenz; Knochenbruch; Osteoporose
First Page:25
Last Page:30
Link to catalogue:185851164X
Institutes:Fakultät III - Medien, Information und Design
DDC classes:610 Medizin, Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell 3.0