title: A Retrospective Longitudinal Database Study of Persistence and Compliance with Treatment of Osteoporosis in Hungary.
abstract: This study assessed persistence and compliance with anti-osteoporosis therapies, and associations between compliance and clinical outcomes (fracture, fracture-related hospitalization and death), in Hungarian women with postmenopausal osteoporosis. The study used the Hungarian National Health Insurance Fund Administration database and included women with PMO aged at least 50 years, for whom a prescription for anti-osteoporosis medication had been filled between 1 January 2004 and 31 December 2013 (index event). Persistence (prescription refilled within 8 weeks of the end of the previous supply) was evaluated over 2 years; good compliance (medication possession ratio ≥ 80 %) was evaluated at 1 year. Associations between compliance and clinical outcomes (data collected for up to 6 years) were assessed with adjustment for baseline covariates. A total of 296,300 women met the inclusion criteria (524,798 index events). Persistence and compliance were higher for less frequent and parenteral therapies (1- and 2-year persistence: half-yearly [parenteral] vs. daily/weekly/monthly [oral and parenteral], 81 and 38 % vs. 21-34 and 10-18 %, respectively; parenteral vs. oral, 75 and 36 % vs. 32 and 16 %; good compliance: half-yearly vs. daily/weekly/monthly, 70 vs. 24-39 %; parenteral vs. oral 78 vs. 36 %). Good compliance significantly reduced the risks of fracture, fracture-related hospitalization and death (relative risk vs. non-compliance [95 % confidence interval]: 0.77 [0.70-0.84], 0.72 [0.62-0.85] and 0.57 [0.51-0.64], respectively; P < 0.01). Improving compliance through long-interval parenteral therapies may result in clinical benefits for patients.
authors.affiliation: 1st Department of Medicine, Semmelweis University, Koranyi 2/A, Budapest, 1083, Hungary. Lakatos.peter@med.semmelweis-univ.hu.
authors.forename: Péter
authors.initials: P
authors.lastname: Lakatos
authors.affiliation: 1st Department of Medicine, Semmelweis University, Koranyi 2/A, Budapest, 1083, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Takács
authors.affiliation: Healthware Tanácsadó Kft., Warehouse u. 30-32, 6th floor. (RiverPark Office Building), 1093, Budapest, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Marton
authors.affiliation: Healthware Tanácsadó Kft., Warehouse u. 30-32, 6th floor. (RiverPark Office Building), 1093, Budapest, Hungary.
authors.forename: Emese
authors.initials: E
authors.lastname: Tóth
authors.affiliation: Healthware Tanácsadó Kft., Warehouse u. 30-32, 6th floor. (RiverPark Office Building), 1093, Budapest, Hungary.
authors.forename: Cina
authors.initials: C
authors.lastname: Zoltan
authors.affiliation: Healthware Tanácsadó Kft., Warehouse u. 30-32, 6th floor. (RiverPark Office Building), 1093, Budapest, Hungary.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Lang
authors.affiliation: Amgen (Europe) GmbH, 23 Dammstrasse, Zug, 6300, Switzerland.
authors.forename: Emi
authors.initials: E
authors.lastname: Psachoulia
authors.affiliation: Amgen (Europe) GmbH, 23 Dammstrasse, Zug, 6300, Switzerland.
authors.forename: Michele
authors.initials: M
authors.lastname: Intorcia
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D003625:Data Collection; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008137:Longitudinal Studies; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology* / Q000628:therapy*; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000517:prevention & control; D010349:Patient Compliance; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents
keywords: Compliance; Death; Fracture; Hospitalization; Osteoporosis; Persistence