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Early discontinuation of treatment for osteoporosis

, : Early discontinuation of treatment for osteoporosis. American Journal of Medicine 115(3): 209-216, August 15

PURPOSE: To identify factors associated with early treatment discontinuation of three agents commonly prescribed for women with low bone density. METHODS: A telephone survey was conducted in 2000 to 2001 in a random sample of women aged 45 years or older who had bone density T-scores -1.0 or lower and who had initiated treatment with hormone replacement therapy, raloxifene, or alendronate. Logistic regression was used to estimate adjusted odds ratios for early treatment discontinuation. RESULTS: Among 956 women who were interviewed an average of 7 months after treatment initiation, 334 were taking hormone therapy, and 88 (26%) had discontinued; 256 were taking raloxifene, and 48 (19%) had discontinued (P=0.03 vs. hormone therapy); and 366 were taking alendronate, and 70 (19%) had discontinued (P=0.02 vs. hormone therapy). Women with bothersome side effects (somewhat bothered: odds ratio (OR)=4.0; 95% confidence interval (CI): 2.5 to 6.5; very or extremely bothered: OR=25; 95% CI: 16 to 39) or who thought that their bone density test results did not show osteoporosis (OR=1.6; 95% CI: 1.0 to 2.5) were more likely to discontinue therapy, as compared with women reporting regular exercise (OR=0.7; 95% CI: 0.4 to 1.0) or a willingness to take prescribed medications (OR=0.6; 95% CI: 0.4 to 0.9). After adjustment for side effects and patient characteristics, the odds of early treatment discontinuation did not differ significantly among treatments. CONCLUSION: Improved adherence to osteoporosis treatment requires that treatment side effects be minimized and women be educated regarding their bone density test results.


PMID: 12947959

DOI: 10.1016/s0002-9343(03)00362-0

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