Treatment satisfaction and persistence among postmenopausal women on osteoporosis medications: 12-month results from POSSIBLE US™
Women in POSSIBLE US™ who expressed greater treatment satisfaction at study entry were more likely to persist with osteoporosis therapy over a 1-year period. Lower satisfaction among women with moderate/severe side effects increased the risk of discontinuation/switching by 67%. Treatment satisfaction and side effect experience influence osteoporosis medication adherence.
Non-adherence is common among women using postmenopausal osteoporosis (PMO) medications. We describe the association between treatment satisfaction, measured with the Treatment Satisfaction Questionnaire for Medication (TSQM), and the risk of discontinuation/switching PMO medications using patient-reported data from a large, longitudinal cohort study.
Data from 2,405 participants in the Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBLE US™) Study were evaluated. Cox proportional hazards regression was used to estimate hazard ratios (HR) for the association between treatment satisfaction at study entry and self-reported discontinuation/switching of pharmacologic PMO medications over a 1-year follow-up period. Logistic regression was used to evaluate relationships between treatment satisfaction, lifestyle behaviors, and compliance with bisphosphonate dosing instructions.
Median TSQM scores were highest (indicating greatest satisfaction) for the side effects domain [n = 1,182; median = 87.5 (Q1 = 75.0, Q3 = 100.0)] and lowest for global satisfaction [n = 2,340; median = 64.0 (Q1 = 55.7, Q3 = 77.7)]. Median scores decreased for the side effects and global satisfaction domains as patient-reported side effect severity increased. Women with higher satisfaction were less likely to discontinue/switch medications than women with lower scores (adjusted HRs for convenience 0.73, 95% CI = 0.63–0.85; effectiveness 0.82, 95% CI = 0.70–0.97; and global satisfaction 0.73, 95% CI = 0.63–0.85). Lower treatment satisfaction was particularly influential among women who reported moderate/severe side effects (HR = 0.60, 95% CI = 0.37–0.97).
Lower treatment satisfaction was associated with a 22% (1/0.82) to 67% (1/0.60) increased risk of discontinuation/switching osteoporosis medication during 1 year of follow-up.
KeywordsDiscontinuation Medication Postmenopausal osteoporosis Switching Treatment satisfaction
- 1.U.S. Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the surgeon general. U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MDGoogle Scholar
- 23.Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR (2004) Validation of a general measure of treatment satisfaction, the treatment satisfaction questionnaire for medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes 2:12PubMedCrossRefGoogle Scholar
- 24.Centers for Disease Control and Prevention. About BMI for Adults. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html 7/27/09. Accessed 6 September 2010
- 31.Pencille LJ, Campbell ME, Van Houten HK, Shah ND, Mullan RJ, Swiglo BA, Breslin M, Kesman RL, Tulledge-Scheitel SM, Jaeger TM, Johnson RE, Bartel GA, Wermers RA, Melton LJ 3rd, Montori VM (2009) Protocol for osteoporosis choice trial. A pilot randomized trial of a decision aid in primary care practice. Trials 10:113PubMedCrossRefGoogle Scholar
- 33.Hadji P, Minne H, Pfeifer M, Bourgeois P, Fardellone P, Licata A, Devas V, Masanauskaite D, Barrett-Connor E (2008) Treatment preference for monthly oral ibandronate and weekly oral alendronate in women with postmenopausal osteoporosis: a randomized crossover study (BALTO II). Joint Bone Spine 75:303–310PubMedCrossRefGoogle Scholar
- 34.Emkey R, Koltun W, Beusterien K, Seidman L, Kivitz A, Devas V, Masanauskaite D (2005) Patient preference for once-monthly ibandronate versus once-weekly alendronate in a randomized, open-label, cross-over trial: the Boniva Alendronate Trial in Osteoporosis (BALTO). Curr Med Res Opin 21:1895–1903PubMedCrossRefGoogle Scholar
- 36.Kendler DL, Bessette L, Hill CD, Gold DT, Horne R, Varon SF, Borenstein J, Wang H, Man HS, Wagman RB, Siddhanti S, Macarios D, Bone HG (2010) Preference and satisfaction with a 6-month subcutaneous injection versus a weekly tablet for treatment of low bone mass. Osteoporos Int 21:837–846PubMedCrossRefGoogle Scholar