Predictors of very low adherence with medications for osteoporosis: towards development of a clinical prediction rule.
In: Osteoporosis International, Jg. 22 (2011-06-01), Heft 6, S. 1737-1743
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Summary: We developed a clinical prediction rule score to predict medication non-adherence for women prescribed osteoporosis treatment. When combined into a summative score, 62% with seven or more points on the score demonstrated very low adherence. This compares with 17% subjects with fewer than seven points ( c-statistic = 0.74). Introduction: Medication non-adherence is extremely common for osteoporosis; however, no clear methods exist for identifying patients at risk of this behavior. We developed a clinical prediction rule to predict medication non-adherence for women prescribed osteoporosis treatment. Methods: Women undergoing bone mineral density testing and fulfilling WHO criteria for osteoporosis were invited to complete a questionnaire and then followed for 1 year. Adjusted logistic regression models were examined to identify variables associated with very low adherence (medication possession ratio <20%). The weighted variables, based on the logistic regression, were summed, and the score was compared with the proportion of subjects with very low adherence. Results: One hundred forty two women participated in the questionnaire and were prescribed an osteoporosis medication. After 1 year, 36% ( n = 50) had very low adherence. Variables associated with very low adherence included prior non-adherence with chronic medications, agreement that side effects are concerning, agreement that she is taking too many medications, lack of agreement that osteoporosis is a worry, lack of agreement that a fracture will cause disability, lack of agreement that medications help her stay active, and frequent use of alcohol. When combined into a summative score, 36 of the 58 subjects (62%) with seven or more points on the score demonstrated very low adherence. This compares with 14 of the 84 (17%) subjects with fewer than seven points ( c-statistic = 0.74). Conclusion: We developed a brief clinical prediction rule that was able to discriminate between women likely (and unlikely) to experience very low adherence with osteoporosis medications. [ABSTRACT FROM AUTHOR]
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Predictors of very low adherence with medications for osteoporosis: towards development of a clinical prediction rule.
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Autor/in / Beteiligte Person: | Solomon, D. H. ; Brookhart, M. A. ; Tsao, P. ; Sundaresan, D. ; Andrade, S. E. ; Mazor, K. ; Yood, R. |
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Zeitschrift: | Osteoporosis International, Jg. 22 (2011-06-01), Heft 6, S. 1737-1743 |
Veröffentlichung: | 2011 |
Medientyp: | academicJournal |
ISSN: | 0937-941X (print) |
DOI: | 10.1007/s00198-010-1381-4 |
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