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Early (1-year) Discontinuation of different anti-osteoporosis medications compared: A population-based cohort study

Early (1-year) Discontinuation of different anti-osteoporosis medications compared: A population-based cohort study
Early (1-year) Discontinuation of different anti-osteoporosis medications compared: A population-based cohort study
Although a number of reports suggest very low persistence with oral bisphosphonates, there is limited data on persistence with other anti-osteoporosis medications. We compare rates of early discontinuation (in the first year) with all available outpatient anti-osteoporosis drugs in Catalonia, Spain. We conducted a population-based retrospective cohort study using data from the SIDIAP database. SIDIAP contains computerized primary care records and pharmacy dispensing data for >80 % of the population of Catalonia (>5 million people). All SIDIAP participants starting an anti-osteoporosis drug between 1/1/2007 and 30/06/2011 (with 2 years wash-out) were included. We modelled persistence as the time between first prescription and therapy discontinuation (refill gap of at least 6 months) using Fine and Gray survival models with competing risk for death. We identified 127,722 patients who started any anti-osteoporosis drug in the study period. The most commonly prescribed drug was weekly alendronate (N = 55,399). 1-Year persistence ranges from 40 % with monthly risedronate to 7.7 % with daily risedronate, and discontinuation was very common [from 49.5 % (monthly risedronate) to 84.4 % (daily risedronate)] as was also switching in the first year of therapy [from 2.8 % (weekly alendronate) to 10 % (daily alendronate)]. Multivariable-adjusted models showed that only monthly risedronate had better one-year persistence than weekly alendronate and teriparatide equivalent, whilst all other therapies had worse persistence. Early discontinuation with available anti-osteoporosis oral drugs is very common. Monthly risedronate, weekly alendronate, and daily teriparatide are the drugs with the best persistence, whilst daily oral drugs have 40–60 % higher first-year discontinuation rates compared to weekly alendronate
electronic health records, epidemiology, medication adherence, osteoporosis, catalonia, primary health care
0171-967X
1-7
Carbonell-Abella, C.
f3dddfc6-9090-4805-95c3-3c77c7f951be
Pages-Castella, A.
1ef31394-0ec4-4235-af93-3fea73ff74c1
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Nogues, X.
7f28b63d-f8db-46f2-a67e-5e94980adc4d
Farmer, A.J.
b3032856-ca99-470e-b55f-771fd51143a0
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Diez-Perez, R.
f1a28f17-4712-44be-bbbc-9c6147d432f3
Carbonell-Abella, C.
f3dddfc6-9090-4805-95c3-3c77c7f951be
Pages-Castella, A.
1ef31394-0ec4-4235-af93-3fea73ff74c1
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Nogues, X.
7f28b63d-f8db-46f2-a67e-5e94980adc4d
Farmer, A.J.
b3032856-ca99-470e-b55f-771fd51143a0
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Diez-Perez, R.
f1a28f17-4712-44be-bbbc-9c6147d432f3

Carbonell-Abella, C., Pages-Castella, A., Javaid, M.K., Nogues, X., Farmer, A.J., Cooper, C. and Diez-Perez, R. (2015) Early (1-year) Discontinuation of different anti-osteoporosis medications compared: A population-based cohort study. Calcified Tissue International, 1-7. (doi:10.1007/s00223-015-0040-3). (PMID:26202819)

Record type: Article

Abstract

Although a number of reports suggest very low persistence with oral bisphosphonates, there is limited data on persistence with other anti-osteoporosis medications. We compare rates of early discontinuation (in the first year) with all available outpatient anti-osteoporosis drugs in Catalonia, Spain. We conducted a population-based retrospective cohort study using data from the SIDIAP database. SIDIAP contains computerized primary care records and pharmacy dispensing data for >80 % of the population of Catalonia (>5 million people). All SIDIAP participants starting an anti-osteoporosis drug between 1/1/2007 and 30/06/2011 (with 2 years wash-out) were included. We modelled persistence as the time between first prescription and therapy discontinuation (refill gap of at least 6 months) using Fine and Gray survival models with competing risk for death. We identified 127,722 patients who started any anti-osteoporosis drug in the study period. The most commonly prescribed drug was weekly alendronate (N = 55,399). 1-Year persistence ranges from 40 % with monthly risedronate to 7.7 % with daily risedronate, and discontinuation was very common [from 49.5 % (monthly risedronate) to 84.4 % (daily risedronate)] as was also switching in the first year of therapy [from 2.8 % (weekly alendronate) to 10 % (daily alendronate)]. Multivariable-adjusted models showed that only monthly risedronate had better one-year persistence than weekly alendronate and teriparatide equivalent, whilst all other therapies had worse persistence. Early discontinuation with available anti-osteoporosis oral drugs is very common. Monthly risedronate, weekly alendronate, and daily teriparatide are the drugs with the best persistence, whilst daily oral drugs have 40–60 % higher first-year discontinuation rates compared to weekly alendronate

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Submitted date: 23 July 2015
e-pub ahead of print date: 23 July 2015
Keywords: electronic health records, epidemiology, medication adherence, osteoporosis, catalonia, primary health care
Organisations: MRC Life-Course Epidemiology Unit

Identifiers

Local EPrints ID: 380104
URI: https://eprints.soton.ac.uk/id/eprint/380104
ISSN: 0171-967X
PURE UUID: f9577771-1ee3-4193-a397-88536fe224dc
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 03 Sep 2015 11:03
Last modified: 18 Jul 2019 14:01

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Contributors

Author: C. Carbonell-Abella
Author: A. Pages-Castella
Author: M.K. Javaid
Author: X. Nogues
Author: A.J. Farmer
Author: C. Cooper ORCID iD
Author: R. Diez-Perez

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