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Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada
SUMMARY: We studied new users of oral bisphosphonates and found that less than half persisted with therapy for 2 years, and interruptions in use were common. During a median observation period of 4.7 years, 10% of patients filled only a single prescription, 37% switched therapies and median cumulati...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer-Verlag
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277689/ https://www.ncbi.nlm.nih.gov/pubmed/21604008 http://dx.doi.org/10.1007/s00198-011-1645-7 |
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author | Burden, A. M. Paterson, J. M. Solomon, D. H. Mamdani, M. Juurlink, D. N. Cadarette, S. M. |
author_facet | Burden, A. M. Paterson, J. M. Solomon, D. H. Mamdani, M. Juurlink, D. N. Cadarette, S. M. |
author_sort | Burden, A. M. |
collection | PubMed |
description | SUMMARY: We studied new users of oral bisphosphonates and found that less than half persisted with therapy for 2 years, and interruptions in use were common. During a median observation period of 4.7 years, 10% of patients filled only a single prescription, 37% switched therapies and median cumulative exposure was 2.2 years. INTRODUCTION: We sought to describe bisphosphonate prescribing, persistence and cumulative exposure among seniors in Ontario, Canada. METHODS: We used Ontario Drug Benefit pharmacy claims to identify residents aged ≥ 66 years who initiated oral bisphosphonate therapy between April 1996 and March 2009. The first date of bisphosphonate dispensing was considered the index date. Persistence with therapy was defined as continuous treatment with no interruption exceeding 60 days. We examined persistence with therapy and the number of extended gaps (>60 days) between prescriptions over time periods ranging from 1 to 9 years. We also identified the proportion of patients filling only a single prescription and switching to a different bisphosphonate, and calculated the median days of exposure irrespective of gaps in therapy. RESULTS: A total of 451,113 eligible new bisphosphonate users were identified: mean age = 75.6 years (SD = 6.9), 84% female, and median follow-up length = 4.7 years. Persistence with therapy declined from 63% at 1 year to 46% at 2 years and 12% at 9 years. Among those with at least 5 years of follow-up (n = 213,029), 61% had one or more extended gaps in bisphosphonate therapy. Overall, 10% of patients filled only a single prescription, 37% switched to a different bisphosphonate and the median exposure was 2.2 years. CONCLUSION: Less than half of patients persisted with bisphosphonate therapy for 2 years and interruptions in therapy were common, with most patients experiencing two or more >60-day gaps in therapy. Interventions are needed to improve persistence with bisphosphonate therapy and reduce the frequency of gaps in treatment. |
format | Online Article Text |
id | pubmed-3277689 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-32776892012-03-01 Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada Burden, A. M. Paterson, J. M. Solomon, D. H. Mamdani, M. Juurlink, D. N. Cadarette, S. M. Osteoporos Int Original Article SUMMARY: We studied new users of oral bisphosphonates and found that less than half persisted with therapy for 2 years, and interruptions in use were common. During a median observation period of 4.7 years, 10% of patients filled only a single prescription, 37% switched therapies and median cumulative exposure was 2.2 years. INTRODUCTION: We sought to describe bisphosphonate prescribing, persistence and cumulative exposure among seniors in Ontario, Canada. METHODS: We used Ontario Drug Benefit pharmacy claims to identify residents aged ≥ 66 years who initiated oral bisphosphonate therapy between April 1996 and March 2009. The first date of bisphosphonate dispensing was considered the index date. Persistence with therapy was defined as continuous treatment with no interruption exceeding 60 days. We examined persistence with therapy and the number of extended gaps (>60 days) between prescriptions over time periods ranging from 1 to 9 years. We also identified the proportion of patients filling only a single prescription and switching to a different bisphosphonate, and calculated the median days of exposure irrespective of gaps in therapy. RESULTS: A total of 451,113 eligible new bisphosphonate users were identified: mean age = 75.6 years (SD = 6.9), 84% female, and median follow-up length = 4.7 years. Persistence with therapy declined from 63% at 1 year to 46% at 2 years and 12% at 9 years. Among those with at least 5 years of follow-up (n = 213,029), 61% had one or more extended gaps in bisphosphonate therapy. Overall, 10% of patients filled only a single prescription, 37% switched to a different bisphosphonate and the median exposure was 2.2 years. CONCLUSION: Less than half of patients persisted with bisphosphonate therapy for 2 years and interruptions in therapy were common, with most patients experiencing two or more >60-day gaps in therapy. Interventions are needed to improve persistence with bisphosphonate therapy and reduce the frequency of gaps in treatment. Springer-Verlag 2011-05-21 2012 /pmc/articles/PMC3277689/ /pubmed/21604008 http://dx.doi.org/10.1007/s00198-011-1645-7 Text en © The Author(s) 2011 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Original Article Burden, A. M. Paterson, J. M. Solomon, D. H. Mamdani, M. Juurlink, D. N. Cadarette, S. M. Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada |
title | Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada |
title_full | Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada |
title_fullStr | Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada |
title_full_unstemmed | Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada |
title_short | Bisphosphonate prescribing, persistence and cumulative exposure in Ontario, Canada |
title_sort | bisphosphonate prescribing, persistence and cumulative exposure in ontario, canada |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3277689/ https://www.ncbi.nlm.nih.gov/pubmed/21604008 http://dx.doi.org/10.1007/s00198-011-1645-7 |
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