Impact on Bisphosphonate Persistence and Compliance: Daily Postprandial Administration

Area of Science:

• Orthopedics
• Pharmacology
• Geriatrics

Background:

• Bisphosphonates (BP) are crucial for osteoporosis treatment but often cause gastrointestinal issues, leading to poor patient compliance.
• Low compliance with BP therapy can hinder its effectiveness in preventing and treating osteoporosis.
• Understanding factors influencing BP adherence is vital for improving patient outcomes.

Purpose of the Study:

• To compare the 1-year persistence and compliance of daily bisphosphonate (BP) therapy.
• To evaluate the impact of medication timing (aperitif vs. postprandial) on BP adherence.
• To assess changes in T-scores as a measure of clinical outcomes in different medication timing groups.

Main Methods:

• A study involving 300 patients prescribed daily BP for osteoporosis following distal radius fractures.
• Patients were divided into two groups: Group 1 (aperitif medication before breakfast) and Group 2 (postprandial medication after breakfast).
• Persistence and compliance were measured using the Medication Possession Ratio (MPR), and bone mineral density was assessed via T-scores after one year.

Main Results:

• Both groups showed significant improvements in bone mineral density (hip and lumbar spine).
• One-year persistence was significantly higher in the postprandial group (73.3%) compared to the aperitif group (48.7%).
• The mean MPR was significantly greater in the postprandial group (0.71) than in the aperitif group (0.66).

Conclusions:

• Administering bisphosphonate (BP) medication after meals (postprandial) significantly enhances patient persistence and compliance.
• Improved adherence to daily BP therapy through postprandial administration leads to better clinical outcomes.
• Medication timing is a critical factor in optimizing the effectiveness of osteoporosis treatment with bisphosphonates.