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Calcified Tissue International

, Volume 97, Issue 6, pp 535–541 | Cite as

Early (1-year) Discontinuation of Different Anti-osteoporosis Medications Compared: A Population-Based Cohort Study

  • C. Carbonell-Abella
  • A. Pages-Castella
  • M. K. Javaid
  • X. Nogues
  • A. J. Farmer
  • C. Cooper
  • A. Diez-Perez
  • D. Prieto-Alhambra
Original Research

Abstract

Although a number of reports suggest very low persistence with oral bisphosphonates, there is limited data on persistence with other anti-osteoporosis medications. We compare rates of early discontinuation (in the first year) with all available outpatient anti-osteoporosis drugs in Catalonia, Spain. We conducted a population-based retrospective cohort study using data from the SIDIAP database. SIDIAP contains computerized primary care records and pharmacy dispensing data for >80 % of the population of Catalonia (>5 million people). All SIDIAP participants starting an anti-osteoporosis drug between 1/1/2007 and 30/06/2011 (with 2 years wash-out) were included. We modelled persistence as the time between first prescription and therapy discontinuation (refill gap of at least 6 months) using Fine and Gray survival models with competing risk for death. We identified 127,722 patients who started any anti-osteoporosis drug in the study period. The most commonly prescribed drug was weekly alendronate (N = 55,399). 1-Year persistence ranges from 40 % with monthly risedronate to 7.7 % with daily risedronate, and discontinuation was very common [from 49.5 % (monthly risedronate) to 84.4 % (daily risedronate)] as was also switching in the first year of therapy [from 2.8 % (weekly alendronate) to 10 % (daily alendronate)]. Multivariable-adjusted models showed that only monthly risedronate had better one-year persistence than weekly alendronate and teriparatide equivalent, whilst all other therapies had worse persistence. Early discontinuation with available anti-osteoporosis oral drugs is very common. Monthly risedronate, weekly alendronate, and daily teriparatide are the drugs with the best persistence, whilst daily oral drugs have 40–60 % higher first-year discontinuation rates compared to weekly alendronate.

Keywords

Electronic health records Epidemiology Medication adherence Osteoporosis Catalonia Primary health care 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors, C Carbonell-Abella, A. Pages-Castella, MK Javaid, X Nogues, AJ Farmer, C Cooper, A Diez-Perez, and D Prieto-Alhambra, declare that they have no conflict of interest.

Statement of Human and Animal Rights and Informed Consent

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • C. Carbonell-Abella
    • 1
    • 2
  • A. Pages-Castella
    • 1
  • M. K. Javaid
    • 3
    • 4
  • X. Nogues
    • 5
  • A. J. Farmer
    • 6
  • C. Cooper
    • 3
    • 4
  • A. Diez-Perez
    • 5
  • D. Prieto-Alhambra
    • 1
    • 3
    • 4
    • 5
  1. 1.GREMPAL Research Group, IDIAP Jordi GolUniversitat Autònoma de BarcelonaBarcelonaSpain
  2. 2.Institut Català de la SalutUniversitat de BarcelonaBarcelonaSpain
  3. 3.Oxford NIHR BRU, NDORMSUniversity of OxfordOxfordUK
  4. 4.MRC Lifecourse Epidemiology UnitSouthamptonUK
  5. 5.Musculoskeletal Research Unit, FIMIMParc Salut Mar, and RETICEFBarcelonaSpain
  6. 6.Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK

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