title: Rates and reasons for lack of persistence with anti-osteoporotic drugs: analysis of the Campania region database.
abstract: Subjects with chronic diseases are more likely to be nonpersistent to pharmacological treatment. Lack of persistence is common among subjects using oral anti-osteoporotic drugs, and leads to increased risk of fragility fracture. The aim of our retrospective study is to analyze the rates and reasons for discontinuation of anti-osteoporotic drugs in the Campania Region. Subjects aged over 40 years were included if they had received at least one prescription for any anti-osteoporotic drugs. Data were obtained from an administrative database of regional data on outpatient drug prescriptions reimbursed by the National Health Service. Patients were followed until the discontinuation of anti-osteoporotic therapy or until the end of the observation period. A total of 30,048 were incident users of anti-osteoporotic drugs: 28,317 (94.2%) females. The mean age of the cohort was 69.0±10.0 years. Weekly bis-phosphonates (51.1%) were the most commonly prescribed drugs. In the overall population, persistence rates were 34.8% after 6 months and 13.4% at one year. A multivariate Cox proportional hazard analysis showed that daily regimen (HR 1.9) treatments remained at higher risk of early discontinuation compared to weekly regimen therapies. Our data showed that the persistence to osteoporosis therapy is significantly worse than reported in literature.
authors.affiliation: Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Iolascon
authors.affiliation: Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gimigliano
authors.affiliation: Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy.
authors.forename: Antimo
authors.initials: A
authors.lastname: Moretti
authors.affiliation: Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Riccio
authors.affiliation: ArSan Regional Health Agency of Campania Region, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Di Gennaro
authors.affiliation: Federico II University Hospital of Naples, Naples, Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Illario
authors.affiliation: CIRFF, Center of Pharmacoeconomics, Federico II University of Naples, Naples, Italy.
authors.forename: Valeria Marina
authors.initials: VM
authors.lastname: Monetti
authors.affiliation: CIRFF, Center of Pharmacoeconomics, Federico II University of Naples, Naples, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Orlando
authors.affiliation: CIRFF, Center of Pharmacoeconomics, Federico II University of Naples, Naples, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Menditto
keywords: anti-osteoporotic drugs; bi-sphosphonates; database; osteoporosis; persistence