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Predictors and Outcomes Associated With Adherence to Weekly Alendronate in US Military Veterans: Clinical Research
Sarah Bou Malham1,2, Benjamin Bowe3,4, Sumon K Sen3
1Washington University in St Louis, St Louis, MO, USA.
Journal of Primary Care & Community Health
|November 30, 2019
Summary
High adherence to weekly alendronate in Veterans is linked to better bone mineral density and fewer fractures. Tobacco use was a predictor of low adherence, while prostate cancer predicted high adherence in males.
Area of Science:
- Pharmacology and Pharmaceutics
- Gerontology and Geriatric Medicine
- Public Health and Epidemiology
Background:
- Poor adherence to oral bisphosphonates poses a significant challenge in osteoporosis management and prevention.
- The Veterans Health Administration (VA) healthcare system presents unique opportunities to enhance medication adherence.
- Understanding adherence predictors and outcomes is crucial for optimizing osteoporosis treatment in veteran populations.
Purpose of the Study:
- To determine adherence rates to weekly alendronate therapy among Veterans.
- To identify predictors associated with medication adherence.
- To investigate the impact of adherence on clinical outcomes, including bone mineral density and fracture risk.
Main Methods:
- Retrospective cohort study utilizing VA databases.
- Adherence measured by medication possession ratio (MPR) and persistence; high adherence defined as MPR ≥80%.
- Regression models analyzed predictors of adherence and the effect of adherence on bone mineral density and incident fractures.
Main Results:
- Of 913 Veterans, 48% achieved high adherence (MPR ≥80%) in the first year.
- Tobacco use was significantly associated with low adherence after adjustment.
- High adherence correlated with a reduced risk of incident fractures, particularly in males.
Conclusions:
- First-year adherence to weekly alendronate is a critical factor influencing long-term clinical outcomes in Veterans.
- Identifying and addressing predictors like tobacco use can improve adherence.
- Optimizing adherence may lead to improved bone mineral density and decreased fracture incidence.