Bisphosphonate Regimen Options May Improve Compliance


WASHINGTON — With elderly patients taking more medications than ever, convenient bisphosphonate regimen options may help reduce the overall medication burden and improve compliance with the osteoporosis therapy, suggest findings from a recent study of prescription trends.

In an investigation of prescription data for 250,286 postmenopausal women, about 65% of those prescribed daily or weekly bisphosphonates were also prescribed one to three concomitant medications, Deborah T. Gold, Ph.D., reported in a poster presented at an international symposium sponsored by the National Osteoporosis Foundation.

What's more, 12% of the study population received four concomitant medications, 7% received five, and 17% received six or more.

On average, the women were taking more than three concomitant medications, a burden shown to increase the risk of noncompliance in elderly patients (Arthritis Rheum. 2004;15[Suppl.]:S513).

Compliance is a significant problem with bisphosphonate therapy, in part because the strict fasting and administration requirements of the osteoporosis drugs can conflict with those of other medications.

Dr. Gold of Duke University, Durham, North Carolina, and colleagues analyzed information from a HIPAA-compliant, longitudinal patient database to determine the degree of concomitant medication use among women prescribed alendronate doses of 5, 10, 35, or 70 mg, or risedronate doses of 5 or 35 mg. The women were aged 50 years and older.

Overall, the mean number of concomitant medications among women who received daily bisphosphonates increased from 3.1 in November 1999 to 4.2 in June 2004.

Among women who received weekly bisphosphonates, the burden of concomitant medications increased from 3.7 drugs in November 2000 to 3.8 in June 2004.

The number of prescribed concomitant medications increased with patient age, from 2.7 to 3.2 among women aged 50–64 years, compared with 3.2 to 4.0 among women aged 75 years and older.

The most common medications prescribed in conjunction with bisphosphonates in this study population were levothyroxine, atorvastatin, atenolol, furosemide, amlodipine, potassium chloride, hydrochlorothiazide, lisinopril, celecoxib, and simvastatin.

The investigators concluded that with greater concomitant medication burden, the convenience of bisphosphonate regimens may have a instrumental effect on adherence.

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