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Osteoporos Int. 2019 Jul 18. doi: 10.1007/s00198-019-05052-0. [Epub ahead of print]

Two-year persistence with teriparatide improved significantly after introduction of an educational and motivational support program.

Author information

1
Department of Internal Medicine, VieCuri Medical Center, Tegelseweg 210, 5912 BL, Venlo, the Netherlands.
2
Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands.
3
NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.
4
Division of Pharmacoepidemiology and Clinical Epidemiology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands.
5
Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center (Maastricht UMC+), Maastricht, the Netherlands.
6
ApotheekZorg, Bladel, the Netherlands.
7
Location VU Medical Center, Department of Rheumatology and Immunology, Amsterdam University Medical Center, Amsterdam, the Netherlands.
8
Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
9
Department of Internal Medicine, VieCuri Medical Center, Tegelseweg 210, 5912 BL, Venlo, the Netherlands. jvdbergh@viecuri.nl.
10
Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands. jvdbergh@viecuri.nl.
11
NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands. jvdbergh@viecuri.nl.
12
Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium. jvdbergh@viecuri.nl.

Abstract

This study evaluated the 2-year persistence with teriparatide in the Netherlands. Analyses showed that the risk of non-persistence was 28% lower in patients who were followed according to an additional educational and motivational support program.

INTRODUCTION:

Until recently, teriparatide (TPTD) was a third-line treatment option for severe osteoporosis in the Netherlands, which could only be prescribed by medical specialists based on a specific medical statement. We aimed to determine whether an educational and motivational support program (EMSP) increased 2-year treatment persistence with TPTD in patients with severe osteoporosis.

METHODS:

We evaluated persistence in 1573 Dutch patients treated with TPTD from January 2013 until January 2018. From January 2013 onwards, all patients received a basic support program (BSP) consisting of an educational home visit to initiate TPTD treatment and phone calls (at 1, 2.5 and 8 weeks). Since May 2015, all patients received the EMSP consisting of the BSP extended with evaluation of medication adherence during phone calls, an additional phone call (at 12 months), and motivational letters at 9 and 14 months.

RESULTS:

The EMSP showed a statistically significantly higher 2-year persistence (78%) with TPTD as compared with the BSP (72%). Reasons for treatment discontinuation were comparable between groups, except for the proportion of patients who had stopped TPTD administration due to side effects, which was significantly lower in the EMSP group (8% vs. 15% in BSP, p < 0.001). Overall, the risk of non-persistence was 28% lower in the EMSP compared with the BSP group (HR: 0.72; 95% CI: 0.55-0.93).

CONCLUSION:

The introduction of the EMSP has demonstrated to improve the persistence with TPTD, resulting in 78% of the patients being persistent with TPTD during the 2-year treatment period.

KEYWORDS:

Educational program; Osteoporosis; Persistence; Support program; Teriparatide

PMID:
31321446
DOI:
10.1007/s00198-019-05052-0

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