Medication possession ratio in postmenopausal osteoporotic patients
a cross sectional study
DOI:
https://doi.org/10.1590/s2175-97902022e19421Keywords:
Osteoporosis, Chronic, Medication, Adherence, ComplianceAbstract
Osteoporosis is a chronic disease of bone that increases risk of low-trauma fracture. Chronic treatment may lead to lower adherence with medication. The current study aims are to determine adherence rate of antiosteoporotic medication by Medication Possession Ratio. Data has been collected from outpatient settings registering cases of postmenopausal osteoporotic women taking medications for an average duration of one year in Karachi. These patients were classified in lower, middle, and affluent socioeconomic classes. Collected data were analyzed by the standardized formula of Medication Possession Ratio and SPSS. Average Medication Possession Ratio ≥80% achieved by Risedronate Brands in the middle class (80.28%±4.41), the affluent class (82.50%±5.09), Raloxifen Brands in affluent class (93.62%±1.57), Gonadotropics in the middle class (81.36%±6.02), affluent class (91.09%±2.05), Alendronate Brands in affluent class (85.42%±5.46). Average Medication Possession Ratio is <80% with all antiosteoporotic medication in the lower class, while the average Medication Possession Ratio of Calcium and Vitamin D is ≥80% in all groups except lower class. Adherence rate was significantly higher among Alendronate group compare to Risedronate (p=0.044). Medication Possession Ratio is greater than 80% among all classes of low-cost antiosteoporotic medications. In addition, patients on once weekly oral medications are more adherent and compliant compare to oral daily or intranasal medications.
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References
Aparasu RR. Sampling methods; Chapter 107. Research methods for pharmaceutical practice and policy. 2016. United Kingdom, Pharmaceutical Press. 1:107-124.
Bone HG, Hosking D, Devogelaer J-P, Tucci JR, Emkey RD, Tonino RP, et al. Ten years’ experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med. 2004;350(12):1189-1199.
Brixen K, Abrahamsen B, Kassem M. Prevention and treatment of osteoporosis in women. Curr Obs Gynae. 2005;15(4):251-258.
Combe B, C Cohen and F Aubin. Equivalence of nasal spray and subcutaneous formulations of salmon calcitonin. Calcif Tissue Int. 1997;61(1):10-15.
Cramer J, Amonkar M, Hebborn A, Suppapanya N. Bisphosphonate dosing influences treatment adherence in postmenopausal women. Osteo Int. 2005a;16(Suppl 3):s24-s28.
Cramer JA, Amonkar MM, Hebborn A, Altman R. Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Current Med Res and Opin. 2005b;21(9):1453-1460.
Cramer JA, Silverman S. Persistence with bisphosphonate treatment for osteoporosis: finding the root of the problem. Am J Med. 2006;119(4):S12-S17.
Cummings SR. Bone density screening: a new level of evidence? Ann Int Med. 2005;142(3):217-219.
Downey TW, Foltz SH, Boccuzzi SJ, Omar MA, Kahler KH. Adherence and persistence associated with the pharmacologic treatment of osteoporosis in a managed care setting. Southern Med J. 2006;99(6):570-576.
Gambacciani M, Levancini M. Management of postmenopausal osteoporosis and the prevention of fractures. Panminerva Med. 2014;56(2):115-131.
Gold D, Silverman S. Compliance with osteoporosis medications: challenges for healthcare providers. Medsc Ob/ Gyn & Women’s Health. 2005;10(1):1-5.
Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, et al. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. JAMA. 1999;282(14):1344-1352.
Kertes J, Dushenat M, Landes Vesterman J, Lemberger J, Bregman J, Friedman N. Factors contributing to compliance with osteoporosis medication. Isr Med Assoc J 2008;10(3):207-213.
Khaliq SA, Saad M, Fatima N, Jamil A, Khan Z, Fatima A. Evaluation of risk factors in progression of osteoporosis among postmenopausal women in karachi, pakistan. J Uni Med Dent Coll. 2017;8(2):17-23.
Kozma CM, Dickson M, Phillips AL, Meletiche DM. Medication possession ratio: implications of using fixed and variable observation periods in assessing adherence with disease-modifying drugs in patients with multiple sclerosis. Patient Prefer Adherence. 2013;7(1):509-516.
McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J. Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas. 2004;48(3):271-287.
Mehta N, Malootian A, Gilligan J. Calcitonin for osteoporosis and bone pain. Curr Pharmaceut Design. 2003;9(32):2659- 2676.
Penning-van Beest FJ, Goettsch WG, Erkens JA, Herings RM. Determinants of persistence with bisphosphonates: a study in women with postmenopausal osteoporosis. Clin Ther. 2006;28(2):236-242.
Raisz LG. Screening for osteoporosis. N Engl J Med . 2005;353(2):164-171.
Reginster J-Y, Rabenda V, Neuprez A. Adherence, patient preference and dosing frequency: understanding the relationship. Bone. 2006;38(4):S2-S6.
Segal E, Tamir A, Ish-Shalom S. Compliance of osteoporotic patients with different treatment regimens. Isr Med Assoc J. 2003;5(12):859-862.
Sheehy O, Kindundu C, Barbeau M, LeLorier J. Adherence to weekly oral bisphosphonate therapy: cost of wasted drugs and fractures. Osteoporos Int. 2009;20(9):1583.
Silverman SL, Watts NB, Delmas PD, Lange JL, Lindsay R. Effectiveness of bisphosphonates on nonvertebral and hip fractures in the first year of therapy: the risedronate and alendronate (REAL) cohort study. Osteoporos Int. 2007;18(1):25-34.
Siris ES, Harris ST, Rosen CJ, Barr CE, Arvesen JN, Abbott TA, et al. Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc. 2006;81(8):1013-1022.
Sperber CM, Samarasinghe SR, Lomax GP. An upper and lower bound of the Medication Possession Ratio. Patient Prefer Adherence . 2017;11(1):1469-1478.
Tanimura T, Jaramillo E, Weil D, Raviglione M, Lönnroth K. Financial burden for tuberculosis patients in low-and middle-income countries: a systematic review. Eur Respir J. 2014;43(6):1763-1775.
Zethraeus N, Ben Sedrine W, Caulin F, Corcaud S, Gathon H-J, Haim M, et al. Models for assessing the cost-effectiveness of the treatment and prevention of osteoporosis. Osteoporos Int. 2002;13(11):841-857.
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