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Prior adherence to statins is a predictor of subsequent adherence and persistence to oral, but not parenteral, osteoporosis medications

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Abstract

Introduction

Although bisphosphonates are effective for treating osteoporosis, patient adherence is variable. We conducted this study to determine if prior adherence with another medication used to treat chronic asymptomatic conditions predicts adherence with bisphosphonates.

Materials and methods

Retrospective cohort study using linked population-level data for the entire Canadian province of Alberta between April 1, 2009 and March 31, 2017. We examined all new users of an oral or parenteral osteoporosis treatment over the age of 20 who had filled at least one statin prescription in the prior 12 months before the start date of the osteoporosis treatment. Adherence was defined based on medication possession ratio (MPR) and > = 80% was deemed good adherence. Persistence was defined as continuous treatment without an interruption of treatment for more than 56 days.

Results

Of 20,612 new users of oral bisphosphonates and 1538 new users of parenteral treatments, prior good adherence with statins was independently associated with both short term [adjusted Odds Ratio (aOR) 1.34 (95% CI 1.26–1.42) at 1 year] and long term [aOR 1.35 (1.20–1.51) at 5 years] adherence with oral bisphosphonates. However, there was no association between prior statin adherence and adherence [OR 0.94 (0.74, 1.20)] or persistence [(OR 0.96 (0.76, 1.22)] with parenteral osteoporosis therapies. Other factors associated with oral bisphosphonate adherence at 1 year included older age, history of bone mineral density scan, and history of pap smear.

Conclusions

Prior adherence to statins is a predictor of subsequent short-term and long-term adherence and persistence with oral bisphosphonates but not parenteral osteoporosis therapies.

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Acknowledgements

Dr. McAlister is supported by the Alberta Health Services Chair in Cardiovascular Outcomes Research. The authors acknowledge the assistance of the Alberta SPOR Support Unit (AbSPORU), funded by CIHR and Alberta Innovates in data access and analysis.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Medicine, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada

    Ambika Gupta

  2. Alberta SPOR Support Unit, 400 College Plaza, 8215 112 Street, Edmonton, AB, T6G 2C8, Canada

    Mu Lin & Finlay A. McAlister

  3. Division of General Internal Medicine, University of Alberta, 5-134C Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada

    Finlay A. McAlister

  4. Division of Rheumatology, Department of Medicine, University of Alberta, 8-130 Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada

    Carrie Ye

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  1. Ambika Gupta
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  2. Mu Lin
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  3. Finlay A. McAlister
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  4. Carrie Ye
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Contributions

Study conception and design: AG, FM, CY. Data acquisition and analysis: ML. Quality assurance and supervision: CY, FM. Writing first draft: AG, CY. Subsequent revisions: All authors. Study Guarantor: CY.

Corresponding author

Correspondence to Ambika Gupta.

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Conflict of interest

None.

Ethical approval/consents

Yes, through the University of Alberta with a waiver of informed consent for participants as this study used de-identified data (Pro00084119).

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Gupta, A., Lin, M., McAlister, F.A. et al. Prior adherence to statins is a predictor of subsequent adherence and persistence to oral, but not parenteral, osteoporosis medications. J Bone Miner Metab 39, 712–718 (2021). https://doi.org/10.1007/s00774-021-01216-3

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  • DOI: https://doi.org/10.1007/s00774-021-01216-3

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