Non-adherence to anti-osteoporotic medications in Taiwan: physician specialty makes a difference View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-02-02

AUTHORS

Shan-Fu Yu, Tsong-Shing Yang, Wen-Chan Chiu, Chung-Yuan Hsu, Ching-Lan Chou, Yu-Jih Su, Han-Ming Lai, Ying-Chou Chen, Chung-Jen Chen, Tien-Tsai Cheng

ABSTRACT

Adherence to anti-osteoporotic regimens gradually decreases over time. We hypothesized that the determinants of non-compliance or non-persistence at different times vary and identified these differences. We used an outpatient database to retrieve information on anti-osteoporotic medications prescribed by a medical centre in southern Taiwan during 2001–2007. Compliance was defined as a medication possession ratio (MPR) ≥80 %. Persistence was determined as continuous use, allowing for a refill gap of 30 days. A multivariate Cox regression model evaluated potential predictors of non-adherence. A total of 3589 patients were included. In the multivariate analyses, non-compliance for both year 1 and year 2 was more likely in patients with non-vertebral non-hip fractures, respiratory disorders, prescription of the first anti-osteoporotic regimen by an orthopedist; and less likely in patients with follow-up bone densitometry and switched regimens. Risks for non-persistence at year 1 and year 2 were generally similar to those for non-compliance; insurance coverage and malignancy were associated with a lower risk of non-persistence at year 1 and year 2, respectively. In the subgroup with an MPR ≥80 % at year 1, an index prescription by an orthopedist was the only independent predictor of non-compliance and non-persistence at year 2. In conclusion, the positive or negative determinants of non-adherence were different at year 1 and year 2, which indicated that clinicians might deliver effective interventions to improve adherence via different precautions annually. This study also provided evidence that physician specialty had a significant effect on adherence to osteoporosis care. More... »

PAGES

351-359

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00774-013-0424-2

DOI

http://dx.doi.org/10.1007/s00774-013-0424-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1049351317

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23377623


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29 schema:description Adherence to anti-osteoporotic regimens gradually decreases over time. We hypothesized that the determinants of non-compliance or non-persistence at different times vary and identified these differences. We used an outpatient database to retrieve information on anti-osteoporotic medications prescribed by a medical centre in southern Taiwan during 2001–2007. Compliance was defined as a medication possession ratio (MPR) ≥80 %. Persistence was determined as continuous use, allowing for a refill gap of 30 days. A multivariate Cox regression model evaluated potential predictors of non-adherence. A total of 3589 patients were included. In the multivariate analyses, non-compliance for both year 1 and year 2 was more likely in patients with non-vertebral non-hip fractures, respiratory disorders, prescription of the first anti-osteoporotic regimen by an orthopedist; and less likely in patients with follow-up bone densitometry and switched regimens. Risks for non-persistence at year 1 and year 2 were generally similar to those for non-compliance; insurance coverage and malignancy were associated with a lower risk of non-persistence at year 1 and year 2, respectively. In the subgroup with an MPR ≥80 % at year 1, an index prescription by an orthopedist was the only independent predictor of non-compliance and non-persistence at year 2. In conclusion, the positive or negative determinants of non-adherence were different at year 1 and year 2, which indicated that clinicians might deliver effective interventions to improve adherence via different precautions annually. This study also provided evidence that physician specialty had a significant effect on adherence to osteoporosis care.
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36 Medical Center
37 Taiwan
38 adherence
39 analysis
40 anti-osteoporotic medication
41 anti-osteoporotic regimens
42 bone densitometry
43 care
44 center
45 clinicians
46 compliance
47 conclusion
48 continuous use
49 coverage
50 database
51 days
52 densitometry
53 determinants
54 differences
55 different precautions
56 different times
57 disorders
58 effect
59 effective interventions
60 evidence
61 fractures
62 gap
63 independent predictors
64 index prescription
65 information
66 insurance coverage
67 intervention
68 lower risk
69 malignancy
70 medication possession ratio
71 medications
72 model
73 multivariate Cox regression model
74 multivariate analysis
75 negative determinant
76 non-hip fractures
77 only independent predictor
78 orthopedists
79 osteoporosis care
80 outpatient database
81 patients
82 persistence
83 physician specialty
84 possession ratio
85 potential predictors
86 precautions
87 predictors
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89 ratio
90 refill gap
91 regimen
92 regimens
93 regression models
94 respiratory disorders
95 risk
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97 southern Taiwan
98 specialties
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