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

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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.

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Acknowledgments

This study was supported by grant CMRPG870592 from Chang Gung Memorial Hospital.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No 123, Ta-Pei Road, Niaosung, 833, Kaohsiung, Taiwan

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

  2. Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan

    Tsong-Shing Yang

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  1. Shan-Fu Yu
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Correspondence to Tien-Tsai Cheng.

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Yu, SF., Yang, TS., Chiu, WC. et al. Non-adherence to anti-osteoporotic medications in Taiwan: physician specialty makes a difference. J Bone Miner Metab 31, 351–359 (2013). https://doi.org/10.1007/s00774-013-0424-2

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  • DOI: https://doi.org/10.1007/s00774-013-0424-2

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