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首页> 外文期刊>International Journal of General Medicine >Discontinuation and reinitiation patterns of osteoporosis treatment among commercially insured postmenopausal women
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Discontinuation and reinitiation patterns of osteoporosis treatment among commercially insured postmenopausal women

机译：商业保险的绝经后妇女中骨质疏松症治疗的停药和重新开始模式

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Objective: Poor adherence to chronic medications is common and compromises medication effectiveness. We sought to describe longitudinal patterns of osteoporosis medication use.Study design: This was a retrospective observational cohort study using 2005–2009 data from a large, commercially insured population.Methods: Patients were women aged ≥55 years initiating osteoporosis therapy who had a ≥12-month (baseline) period with no osteoporosis therapy claims preceding initiation, and ≥24 months follow-up after therapy initiation. Discontinuation was defined as a gap >60 days (varied in sensitivity analyses) in prescription claims. Reinitiation was defined as a prescription claim for the same or different osteoporosis therapy following the therapy gap. Discontinuation and reinitiation patterns were described using Kaplan–Meier analysis. Multivariable Cox regression assessed the impact of baseline factors on reinitiation.Results: Of the 92,839 patients, 45%, 58%, and 70% discontinued therapy at 6, 12, and 24 months, respectively, following initiation. Of the discontinuers, 46% reinitiated therapy, with the majority doing so within 6 months of discontinuation. Women were less likely to reinitiate therapy if they were older (P < 0.0001) or were hospitalized during baseline (P = 0.0007). Women who discontinued treatment early (<6 months) following initiation were less likely to reinitiate (P < 0.0001) and remained on therapy for shorter periods following reinitiation. Depending on the available observation time, the median time on therapy following reinitiation was 58–193 days. Study findings did not change appreciably in sensitivity analyses.Conclusion: Many patients stop and restart treatment for osteoporosis. A better understanding of determinants of treatment stopping and restarting could inform adherence improvement efforts.
机译：目的：对慢性药物的依从性差是普遍现象，会损害药物治疗的有效性。我们试图描述骨质疏松症药物使用的纵向模式。研究设计：这是一项回顾性观察队列研究，使用了来自大量商业保险人群的2005-2009年数据。方法：患者为≥55岁的开始骨质疏松症治疗且≥开始治疗前需要进行12个月（基线）的治疗，无骨质疏松症治疗，治疗开始后需要进行≥24个月的随访。停药被定义为处方声明中的间隔> 60天（灵敏度分析中有所不同）。重新开始定义为在治疗间隔后针对相同或不同骨质疏松症治疗的处方要求。使用Kaplan-Meier分析描述了停产和重新初始化的模式。结果：在92,839名患者中，开始治疗后第6、12和24个月分别中断了治疗的92,839名患者中的45％，58％和70％停止治疗。在停药者中，有46％重新开始治疗，大多数在停药后6个月内重新开始。如果女性年龄较大（P <0.0001）或在基线期间住院（P = 0.0007），则女性不太可能重新开始治疗。在启动后早期（<6个月）停止治疗的妇女重新启动的可能性较小（P <0.0001），并且在重新启动后停留治疗的时间较短。根据可用的观察时间，重新开始治疗后的中位时间为58-193天。研究结果在敏感性分析中没有明显改变。结论：许多患者停止并重新开始骨质疏松症的治疗。更好地了解停止和重新开始治疗的决定因素可能有助于坚持治疗的努力。

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