In an online survey, prescribers of bisphosphonates for osteoporosis (OA) appears to prefer monthly over weekly dosing regimens, and tended to guide their decision to initiate bisphosphnate therapy based on patient fracture risk. Findings are published in Clinical Interventions in Aging.
Researchers set out to study physicians’ prescribing considerations, preference for OA therapies, and view of patients’ compliance with oral bisphosphonates. They surveyed 158 physicians identified in the HealthCore Integrated Research Database (HIRD) that prescribed oral bisphosphonates to females aged ≥55 years old. Physicians were asked to predict patient persistence and compliance and assess possible reasons for noncompliance.
Major considerations when deciding whether to treat a patient for OA were bone mineral density (94.9%), long-term medication use such as corticosteroids (88.6%), and a history of fracture (86.7%). Most physicians showed a preference for prescribing weekly (54.4%) or monthly (34.2%) oral bisphosphonates for both newly diagnosed patients and long-term users (40.5% and 36.1%, respectively). A drug holiday was always incorporated into their prescribing regimens by 23.4% of physicians and sometimes incorporated by 58.9% of physicians.
Regarding compliance, 17.7% of physicians predicted that less than half of patient would be compliant in the first year, and 29.7% predicted compliance past 1 year. Among surveyed physicians, major reasons for noncompliance with oral bisphosphonates were drug intolerance due to a gastrointestinal condition (71.5%) and drug side effects (69.6%).
Summary and Clinical Applicability
In this online survey of bisphosphonate prescribers in the US, clinicians appears to prefer monthly over weekly dosing regimens, and tended to guide their decision to initiate bisphosphnate therapy based on fracture risk. A major reason identified for medication noncompliance was related to the gastrointestinal side effects of bisphosphonates, with prescribers being cognizant that less frequent dosing may decrease the occurrence of these effects.
Gu T, Eisenberg lawrence DF, Stephenson JJ, Yu J. Physicians’ perspectives on the treatment of osteoporosis patients with bisphosphonates. Clin Interv Aging. 2016;11:1-8.
This article originally appeared on MPR