Assessment of patient-reported outcomes (PROs): treatment satisfaction, medication adherence, and quality of life (QoL) and the associated factors in postmenopausal osteoporosis (PMO) patients in Korea
- 387 Downloads
Patient-reported outcomes (PROs) provide practical guides for treatment; however, studies that have evaluated PROs of women in Korea with postmenopausal osteoporosis (PMO) are lacking. This cross-sectional, multi-center (29 nationwide hospitals) study, performed from March 2013 to July 2014, aimed to assess PROs related to treatment satisfaction, medication adherence, and quality of life (QoL) in Korean PMO women using osteoporosis medication for prevention/treatment. Patient demographics, clinical characteristics, treatment patterns, PROs, and experience using medication were collected. The 14-item Treatment Satisfaction Questionnaire for Medication (TSQM) (score-range, 0–100; domains: effectiveness, side effects, convenience, global satisfaction), Osteoporosis-Specific Morisky Medication Adherence Scale (OS-MMAS) (score-range, 0–8), and EuroQol-5 dimensions questionnaire (index score range, − 0.22 to 1.0; EuroQol visual analog scale score range, 0–100) were used. To investigate factors associated with PROs, linear (treatment satisfaction/QoL) or logistic (medication adherence) regression analyses were conducted. A total of 1804 patients (age, 62 years) were investigated; 60.1% used bisphosphonate, with the majority (67.2%) using weekly medication, 27.8% used daily hormone replacement therapy, and 12.1% used daily selective estrogen receptor modulator. Several patients reported gastrointestinal (GI) events (31.6%) and dental visits due to problems (24.1%) while using medication. Factors associated with the highest OS-MMAS domain scores were convenience and global satisfaction. GI events were associated with non-adherence. TSQM scores for effectiveness, side effects, and GI risk factors were significantly associated with QoL. Our study elaborately assessed the factors associated with PROs of Korean PMO women. Based on our findings, appropriate treatment-related adjustments such as frequency/choice of medications and GI risk management may improve PROs.
KeywordsPostmenopausal osteoporosis Treatment satisfaction Medication adherence Quality of life Gastrointestinal events
This research was sponsored by Pfizer.
Compliance with ethical standards
Statement of human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of interest
All authors have no conflicts of interest.
- 2.Choi YJ, Oh HJ, Kim DJ, Lee Y, Chung YS (2012) The prevalence of osteoporosis in Korean adults aged 50 years or older and the higher diagnosis rates in women who were beneficiaries of a national screening program: the Korea National Health and Nutrition Examination Survey 2008–2009. J Bone Miner Res 27:1879–1886. https://doi.org/10.1002/jbmr.1635 CrossRefGoogle Scholar
- 3.Anonymous (1993) Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 94:646–650Google Scholar
- 9.Chapurlat R, Delmas PD (2004) Treatment of postmenopausal osteoporosis. Rev Prat (Traitement de l’osteoporose post-menopausique) 54:2120–2126Google Scholar
- 10.Hellstein JW, Adler RA, Edwards B, Jacobsen PL, Kalmar JR, Koka S, Migliorati CA, Ristic H, American Dental Association Council on Scientific Affairs Expert Panel on Antiresorptive A (2011) Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: executive summary of recommendations from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 142:1243–1251CrossRefPubMedGoogle Scholar
- 11.Pasion EG, Sivananthan SK, Kung AW, Chen SH, Chen YJ, Mirasol R, Tay BK, Shah GA, Khan MA, Tam F, Hall BJ, Thiebaud D (2007) Comparison of raloxifene and bisphosphonates based on adherence and treatment satisfaction in postmenopausal Asian women. J Bone Miner Metab 25:105–113. https://doi.org/10.1007/s00774-006-0735-7 CrossRefPubMedGoogle Scholar
- 13.Valderas JM, Kotzeva A, Espallargues M, Guyatt G, Ferrans CE, Halyard MY, Revicki DA, Symonds T, Parada A, Alonso J (2008) The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature. Qual Life Res 17:179–193. https://doi.org/10.1007/s11136-007-9295-0 CrossRefPubMedGoogle Scholar
- 16.Zyoud SH, Al-Jabi SW, Sweileh WM, Morisky DE (2013) Relationship of treatment satisfaction to medication adherence: findings from a cross-sectional survey among hypertensive patients in Palestine. Health Qual Life Outcomes 11:191. https://doi.org/10.1186/1477-7525-11-191 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Ringe JD, Moller G (2009) Differences in persistence, safety and efficacy of generic and original branded once weekly bisphosphonates in patients with postmenopausal osteoporosis: 1-year results of a retrospective patient chart review analysis. Rheumatol Int 30:213–221. https://doi.org/10.1007/s00296-009-0940-5 CrossRefPubMedGoogle Scholar
- 22.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 2:12. https://doi.org/10.1186/1477-7525-2-12 CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Reynolds K, Viswanathan HN, Muntner P, Harrison TN, Cheetham TC, Hsu JW, Gold DT, Silverman S, Grauer A, Morisky DE, O’Malley CD (2014) Validation of the Osteoporosis-Specific Morisky Medication Adherence Scale in long-term users of bisphosphonates. Qual Life Res 23:2109–2120. https://doi.org/10.1007/s11136-014-0662-3 CrossRefPubMedGoogle Scholar
- 24.Lee YK, Nam HS, Chuang LH, Kim KY, Yang HK, Kwon IS, Kind P, Kweon SS, Kim YT (2009) South Korean time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. Value Health 12:1187–1193. https://doi.org/10.1111/j.1524-4733.2009.00579.x CrossRefPubMedGoogle Scholar
- 28.Turbi C, Herrero-Beaumont G, Acebes JC, Torrijos A, Grana J, Miguelez R, Sacristan J, Marin F (2004) Compliance and satisfaction with raloxifene versus alendronate for the treatment of postmenopausal osteoporosis in clinical practice: an open-label, prospective, nonrandomized, observational study. Clin Ther 26:245–256CrossRefPubMedGoogle Scholar
- 29.Barrett-Connor E, Wade SW, Do TP, Satram-Hoang S, Stewart R, Gao G, Macarios D (2010) Treatment satisfaction and persistence among postmenopausal women on osteoporosis medications: 12-month results from POSSIBLE US™. Osteoporos Int 23:733–741Google Scholar
- 36.Hong SM, Choi WH (2011) Osteoporosis and decrease in bone mineral density have associated with the reduced quality of life. Osteoporosis 9:175–179Google Scholar
- 38.Cranney A, Tugwell P, Adachi J, Weaver B, Zytaruk N, Papaioannou A, Robinson V, Shea B, Wells G, Guyatt G, Osteoporosis Methodology G, The Osteoporosis Research Advisory G (2002) Meta-analyses of therapies for postmenopausal osteoporosis. III. Meta-analysis of risedronate for the treatment of postmenopausal osteoporosis. Endocr Rev 23:517–523. https://doi.org/10.1210/er.2001-3002 CrossRefPubMedGoogle Scholar
- 40.Eekman DA, Vis M, Bultink IE, Derikx HJ, Dijkmans BA, Lems WF (2009) Treatment with intravenous pamidronate is a good alternative in case of gastrointestinal side effects or contraindications for oral bisphosphonates. BMC Musculoskelet Disord 10:86. https://doi.org/10.1186/1471-2474-10-86 CrossRefPubMedPubMedCentralGoogle Scholar
- 41.Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, Satterfield S, Wallace RB, Bauer DC, Palermo L, Wehren LE, Lombardi A, Santora AC, Cummings SR, Group FR (2006) Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA 296:2927–2938. https://doi.org/10.1001/jama.296.24.2927 CrossRefPubMedGoogle Scholar
- 42.Huas D, Debiais F, Blotman F, Cortet B, Mercier F, Rousseaux C, Berger V, Gaudin AF, Cotté FE (2010) Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment. BMC Womens Health 10:26. https://doi.org/10.1186/1472-6874-10-26 CrossRefPubMedPubMedCentralGoogle Scholar