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Patients’ reasons for adhering to long-term alendronate therapy

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Abstract

Summary

We aimed to determine patients’ reasons for continuing alendronate therapy over 5 years by administering a questionnaire. Bone mineral density, fractures, drugs, Charlson comorbidity index, and lifestyle factors were also considered. Education and awareness of the disease appeared highly associated with good alendronate adherence while worsening health status with discontinuation.

Introduction

Aim of this study was to investigate patients’ reasons for adhering to long-term alendronate therapy (more than 5 years), as data is not available in the current literature regarding the reasons behind long-term adherence.

Methods

We studied 204 long-term adherent alendronate users: 65 postmenopausal outpatients still adherent (group C, years on treatment = 8.70 ± 1.31) were compared to 139 age-matched patients who discontinued therapy (group S, years on treatment = 8.64 ± 1.43). We evaluated main biochemical parameters, BMD values, fractures, and Charlson comorbidity index (CCI). A questionnaire was administered to analyze the reasons for long-term adherence.

Results

There were no significant differences between groups concerning baseline DXA values, number of fractures, and CCI. A higher education level was observed in group C (C 54% vs S 35% of patients, p = 0.001). At the time of interview, there was a significantly higher number of patients with a CCI of two in group S compared to the beginning of treatment (56% vs 43%, p = 0.04), together with a higher number of patients taking more than 3 drugs (22% vs 11%, p = 0.01) compared to basal evaluation. Forty-seven percent of patients reported new diseases during the treatment as the main reason for stopping alendronate. A multivariate, stepwise logistic regression analysis showed that awareness of the disease was highly associated with adherence (OR = 0.20; 95% CI 0.045–0.93, p = 0.04) followed by higher education (OR = 0.526, 95% CI 0.345–0.801, p = 0.003). Worsening of CCI was associated with discontinuation (OR = 2.75, 95% CI 1.033–7.324, p = 0.04).

Conclusions

Education and disease awareness are associated with long-term alendronate adherence while competing health problems negatively impact adherence.

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Disciplines, “Sapienza” University, Rome, Italy

    J. Pepe, C. Cipriani, V. Cecchetti, G. Della Grotta, V. Danese, L. Colangelo & S. Minisola

  2. Department of Public Health and Infectious Diseases, “Sapienza” University, Rome, Italy

    C. Ferrara

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  1. J. Pepe
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  2. C. Cipriani
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  3. V. Cecchetti
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  4. C. Ferrara
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Pepe, J., Cipriani, C., Cecchetti, V. et al. Patients’ reasons for adhering to long-term alendronate therapy. Osteoporos Int 30, 1627–1634 (2019). https://doi.org/10.1007/s00198-019-05010-w

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  • DOI: https://doi.org/10.1007/s00198-019-05010-w

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