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Adherence with bisphosphonate therapy in us veterans with rheumatoid arthritis.
MedLine Citation:
PMID:  22740421     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Pharmacy Benefits Management Program (PBM) data for patients enrolled in the Veterans Affairs Rheumatoid Arthritis (VARA) Registry were linked with clinical data to determine bisphosphonate adherence and persistence among U.S. Veterans with RA and determine factors associated with adherence. METHODS: The primary outcome measures were the duration of bisphosphonate therapy and the medication possession ratio (MPR). Patients with a MPR < 0.80 were classified non-adherent. Potential covariates considered in the analysis included patient demographics, RA disease activity and severity parameters, and factors associated with osteoporosis risk. Associations of patient factors with duration of therapy and adherence and were examined using multivariable regression modeling. RESULTS: Bisphosphonates were prescribed to 573 (41.5%) of 1382 VARA subjects. The mean duration of therapy for bisphosphonates was 39.2 (±31.4) months. Longer duration of therapy correlated with older age, a higher level of education and DXA testing. The mean MPR of VARA subjects for bisphosphonate therapy was 0.69 (± 0.28); 302 (52.7%) were non-adherent. In multivariate analyses, non-adherence with bisphosphonate therapy was associated with longer duration of RA (OR 1.02; 95% CI 1.00, 1.04) and duration of bisphosphonate therapy > 32 months (OR 1.63; 95% CI 1.04, 2.57). Caucasians were less likely to have a low MPR compared with non-Caucasians (OR 0.52; 95% CI 0.30, 0.88). CONCLUSIONS: Non-adherence with bisphosphonates was common in this cohort of RA patients and associated with non-Caucasian ethnicity a longer duration of RA and a longer duration of bisphosphonate therapy. © 2012 by the American College of Rheumatology.
J Steuart Richards; Grant W Cannon; Candace L Hayden; Richard L Amdur; Deana Lazaro; Ted R Mikuls; Andreas M Reimold; Liron Caplan; Dannette S Johnson; Pascale Schwab; Bogdan N Cherascu; Gail S Kerr
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-27
Journal Detail:
Title:  Arthritis care & research     Volume:  -     ISSN:  2151-4658     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 by the American College of Rheumatology.
VA Medical Center and Georgetown University, Washington, DC.
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