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Calabria S, Cinconze E, Rossini M, et al. Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis. Patient Prefer Adherence. 2016;10:523-30doi: 10.2147/PPA.S95634.
Calabria, S., Cinconze, E., Rossini, M., Rossi, E., Maggioni, A. P., Pedrini, A., & De Rosa, M. (2016). Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis. Patient preference and adherence, 10523-30. https://doi.org/10.2147/PPA.S95634
Calabria, S, et al. "Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis." Patient preference and adherence vol. 10 (2016): 523-30. doi: https://doi.org/10.2147/PPA.S95634
Calabria S, Cinconze E, Rossini M, Rossi E, Maggioni AP, Pedrini A, De Rosa M. Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis. Patient Prefer Adherence. 2016 Apr 19;10:523-30. doi: 10.2147/PPA.S95634. eCollection 2016. PMID: 27143860; PMCID: PMC4844437.
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Patient Prefer Adherence. 2016 Apr 19;10:523-30. doi: 10.2147/PPA.S95634. eCollection 2016.

Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis.

Patient preference and adherence

S Calabria, E Cinconze, M Rossini, E Rossi, A P Maggioni, A Pedrini, M De Rosa

Affiliations

  1. CORE, Collaborative Outcome Research, Bologna, Italy.
  2. Health Care Systems Department, CINECA, Interuniversity Consortium, Bologna, Italy.
  3. Rheumatology Unit, University of Verona, Verona, Italy.
  4. CORE, Collaborative Outcome Research, Bologna, Italy; ANMCO Research Center, Firenze, Italy.

PMID: 27143860 PMCID: PMC4844437 DOI: 10.2147/PPA.S95634

Abstract

PURPOSE: Osteoporosis is a chronic disease and an important health and social burden due to its worldwide prevalence. Literature and clinical experience report incomplete adherence to the therapy. This retrospective observational study aimed at assessing the adherence to first-line antiosteoporosis drugs (AODs; reimbursed by the National Health System, according to the Italian Medicine Agency recommendation number 79), alendronate or risedronate, with or without calcium and/or vitamin D supplements, in a real, Italian clinical setting.

PATIENTS AND METHODS: Analyses were carried out on data present in the ARNO Observatory, a population-based patient-centric Italian database. From a population of 5,808,832 inhabitants with available data, a cohort of 3.3 million of patients aged ≥40 years was selected. New users of first-line AODs as monotherapy (accrual period, 2007-2009) were followed up over 3 years to assess adherence at 6, 12, and 36 months to AODs and to supplements and related determinants.

RESULTS: Approximately 40,000 new users were identified: mostly women, aged on average (standard deviation) 71±10 years. Alendronate was the most prescribed (38.2% of patients), followed by risedronate (34.9%) and alendronate with colecalciferol as a fixed-dose combination (25.8%). Adherence at the 6-month follow-up was 54%, and this constantly and significantly decreased after 1 year to 46%, and after 3 years to 33% (P<0.01). Adherence to the fixed-dose combination was higher than to plain alendronate throughout the follow-up period. Similarly, adherence to supplements constantly decreased with the duration of treatment. Women and patients aged >50 years were more likely to adhere to treatment regimen (P<0.001). The use of drugs for peptic ulcer and gastroesophageal reflux disease and of corticosteroids for systemic use were significantly associated with high adherence at different times. Polytherapy (>5 drugs), cardiovascular, and neurological therapies were significantly associated with low adherence throughout the follow-up period.

CONCLUSION: In a huge clinical practice sample, this study highlights suboptimal adherence to first-line AODs and to supplements and important determinants, such as concomitant therapies.

Keywords: adherence; bisphosphonates; colecalciferol; determinants; osteoporosis

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