Adherence with bisphosphonate therapy in us veterans with rheumatoid arthritis
Arthritis Care & Research , 06/29/2012
Richards JS et al. – Non–adherence with bisphosphonates was common in this cohort of RA patients and associated with non–Caucasian ethnicity a longer duration of RA and a longer duration of bisphosphonate therapy.Methods
- The primary outcome measures were the duration of bisphosphonate therapy and the medication possession ratio (MPR).
- Patients with a MPR < 0.80 were classified non–adherent.
- Potential covariates considered in the analysis included patient demographics, RA disease activity and severity parameters, and factors associated with osteoporosis risk.
- Associations of patient factors with duration of therapy and adherence and were examined using multivariable regression modeling.
- Bisphosphonates were prescribed to 573 (41.5%) of 1382 VARA subjects.
- The mean duration of therapy for bisphosphonates was 39.2 (±31.4) months.
- Longer duration of therapy correlated with older age, a higher level of education and DXA testing.
- The mean MPR of VARA subjects for bisphosphonate therapy was 0.69 (± 0.28); 302 (52.7%) were non–adherent.
- In multivariate analyses, non–adherence with bisphosphonate therapy was associated with longer duration of RA (OR 1.02; 95% CI 1.00, 1.04) and duration of bisphosphonate therapy > 32 months (OR 1.63; 95% CI 1.04, 2.57).
- Caucasians were less likely to have a low MPR compared with non–Caucasians (OR 0.52; 95% CI 0.30, 0.88).