Early discontinuation of treatment for osteoporosis.
OBJECTIVE
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, oral endronate. 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.


CONCLUSIONS
Improved adherence to osteoporosis treatment requires that treatment side effects be minimized and women be educated regarding their bone density test results.
Tosteson
Anna N A
AN
Department of Medicine, Dartmouth Medical School, Hannover, New Hampshire 03756, USA. Anna.Tosteson@Dartmouth.edu
Grove
Margaret R
MR
Hammond
Cristina S
CS
Moncur
Megan M
MM
Ray
G Thomas
GT
Hebert
Gwen M
GM
Pressman
Alice R
AR
Ettinger
Bruce
B
D019386:Alendronate / Q000009:adverse effects / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy; D001943:Breast Neoplasms / Q000517:prevention & control; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000517:prevention & control; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D020849:Raloxifene Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use*; D016312:Treatment Refusal / Q000706:statistics & numerical data*
D020849:Raloxifene Hydrochloride; D019386:Alendronate