Published Papers - Abstract 355

Berecki J, Hockey R & Dobson A Adherence to bisphosphonate treatment by elderly women. Menopause, 2008; 15(5): 984-990

Objective: The aim of this study was to evaluate the relationship between adherence to bisphosphonate treatment by postmenopausal women and demographic, health, and lifestyle factors before treatment in a country with universal subsidies for pharmaceutical costs.Design: Older women participating in the Australian Longitudinal Study on Women’s Health who consented to linkage to Pharmaceutical Benefits Scheme claims data were included if they filled a bisphosphonate prescription between 2002 and 2005 after a medication-free interval of 180 days (N = 788). A Cox proportional hazards modelwas used to assess the association of baseline variables with duration of adherence to bisphosphonate treatment.Results: The median time until discontinuation of bisphosphonate treatment was 170 days (95% CI: 154<186). Accounting for socioeconomic status, the baseline variables that were associated with adherence failure were use of acid-related medications (hazard ratio = 1.25, 95% CI: 1.01<1.55) and smoking (hazard ratio = 1.82, 95% CI: 1.26<2.64); reporting high levels of physical activity was associated with better adherence (HR = 0.69, 95% CI: 0.52<0.92).Conclusions: Overall adherence to bisphosphonate treatment among older Australian women with a fracture history was poor. Inquiring about acid-related disorders and health behavior such as smoking and lack of physical activity could help the prescribing physician to identify women at risk of nonadherence.