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Factors Associated with Persistence with Teriparatide Therapy: Results from the DANCE Observational Study
Deborah T Gold1, David L Weinstein, Gerhardt Pohl
1Departments of Psychiatry and Behavioral Sciences, Sociology, and Psychology and Neuroscience, Duke University Medical Center, Durham, NC 27710, USA.
Insights
Patient-reported reasons for stopping teriparatide include side effects, cost, and physician-related issues. Managing these factors is key to improving treatment persistence with teriparatide.
Area of Science:
- Pharmacology
- Patient Adherence
- Health Services Research
Background:
- Teriparatide is a critical treatment for osteoporosis.
- Understanding patient-reported discontinuation reasons is vital for improving long-term adherence.
Purpose of the Study:
- To identify and analyze patient-reported reasons for discontinuing teriparatide therapy.
- To differentiate between early and late discontinuation factors.
Main Methods:
- A prospective, observational study involving patients on teriparatide.
- Utilized baseline and follow-up questionnaires at 2-6 months (QF1) and 12 months (QF2).
- Employed Cochran-Armitage trend test to analyze discontinuation factors.
Main Results:
- Early discontinuation linked to side effects, improper use concerns, injection difficulties, and physician issues.
- Late discontinuation associated with perceived low treatment importance, side effects, cost, and perceived physician knowledge gaps.
- Most common reasons: "concerns about treatment outweighing the benefits" and "difficulty paying".
Conclusions:
- Teriparatide persistence hinges on effective side effect management.
- Addressing financial barriers and providing adequate training are crucial.
- Strong healthcare provider support and perceived physician knowledge positively influence treatment continuation.
Abstract:
Purpose. Determine patient-reported reasons for discontinuation with teriparatide. Methods. Patients taking teriparatide in a multicenter, prospective, and observational study were given three questionnaires: baseline, follow-up questionnaire 1 (QF1, 2 to 6 months), and follow-up questionnaire 2 (QF2, 12 months). Discontinuation reported at QF1 and QF2 was defined as "early" and "late," respectively, and remaining patients were considered persistent. Cochran-Armitage trend test was used to identify factors associated with discontinuation. Results. Side effects, concern about improper use, injection difficulties, and several patient-perceived physician issues were associated with early discontinuation. Low patient-perceived importance of continuing treatment, side effects, difficulty paying, and low patient-perceived physician knowledge were associated with late discontinuation. The most common specific reasons selected for discontinuing treatment were "concerns about treatment outweighing the benefits" (n = 53) and "difficulty paying" (n = 47). Conclusions. Persistence with teriparatide is dependent on managing side effects, addressing financial challenges, proper training, and obtaining support from the healthcare provider.
