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Arthritis Care Res (Hoboken). 2012 Jul;64(7):1054-60. doi: 10.1002/acr.21638.

Adherence with intravenous zoledronate and intravenous ibandronate in the United States Medicare population.

Author information

  • 1University of Alabama at Birmingham, AL, USA. jcurtis@uab.edu

Abstract

OBJECTIVE:

To evaluate adherence to drug therapy among new users of zoledronate and intravenous (IV) ibandronate among US Medicare enrollees.

METHODS:

We used data from the Medicare 5% random sample to evaluate new users of IV zoledronate and IV ibandronate with continuous Part A and Part B fee-for-service coverage. The outcome was adherence as quantified by the proportion of days covered (PDC) measured continuously and dichotomously (≥ 80%). Followup time extended from 18-27 months for all individuals. Factors associated with low adherence to zoledronate were evaluated with logistic regression.

RESULTS:

We identified 775 new users of zoledronate and 846 new users of IV ibandronate. For both drugs, 30-48% of the first infusions were given in an outpatient infusion center, not in a physician's office. The mean PDC for zoledronate users was 82%, which was greater than the mean PDC for the IV ibandronate users (58-62% depending on the time period; P < 0.0001). Approximately 30% of zoledronate users did not receive a second infusion. Factors associated with low adherence to zoledronate included older age and receipt of the first infusion in an outpatient infusion center rather than a physician's office.

CONCLUSION:

Less frequently dosed IV bisphosphonates have not resolved the problem of suboptimal adherence with prescription osteoporosis medications. Interventions continue to be warranted to improve long-term adherence to osteoporosis treatments.

Copyright © 2012 by the American College of Rheumatology.

PMID:
22328117
[PubMed - indexed for MEDLINE]
PMCID:
PMC3355221
Free PMC Article
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