• 作者：A. Sicras Mainar^a ; ^{asicras@bsa.cat} ; R. Navarro Artieda^b ; L. Gutié ; rrez Nicuesa^c ; F. Sorio Vilela^c ; M. Intorcia^c
• 关键词：Osteoporosis ; Tratamiento ; Persistencia ; Atenció ; n Primaria
• 刊名：Farmac茅uticos de Atenci贸n Primaria
• 出版年：2011
• 期刊代码：pca387_21723761
• 类别：pha
• 出版时间：2011
• 卷：9
• 期：2
• 页码：46-53
• 文件大小：130 K

Objective

To assess persistence to treatments for postmenopausal osteoporosis in primary care.

Material and methodology

This retrospective, observational study was carried out in six Primary Care centers. Inclusion criteria: osteoporotic women 50 years or older, who initiated an oral treatment with bisphosphonates, raloxifene or strontium ranelate, between January 2004 and June 2008. The primary objective was to estimate persistence to treatment combining all treatments and by drug and regimen. In a primary analysis, switching treatments for postmenopausal osteoporosis was considered discontinuation, whereas in a secondary analysis, switching was allowed. Both analyses were performed on three follow-up-based cohorts according to data availability at 1, 2 and 3 years. Main statistical analyses performed were Kaplan-Meier curves, logistic regression and an ANCOVA model.

Results

A total of 3,049 osteoporotic women were included. Pharmacological groups: 65%were treated with bisphosphonates, 30%with raloxifene and 5%with strontium ranelate. Mean age was 68 years; average Charlson co-morbidity index was 0.4. In cohort 1 (N = 3,049), persistence was 30%; in cohort 2 (N = 2,698), it was 35%and 16%at 1 and 2 years, respectively; in cohort 3 (N = 2,163), it was 36%, 20%and 9%at 1, 2 and 3 years, respectively (p < 0.01). Median duration of persistence to alendronic acid, risedronic acid, raloxifene and strontium ranelate was 149, 178, 210 and 89 days, respectively (p < 0.001). Variables associated with discontinuation were dementia, bone fractures and age.

Conclusions

Persistence to treatment for osteoporosis was low. New strategies are needed to improve the persistence of treatments.