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. 2017 Apr 27:11:839-843.
doi: 10.2147/PPA.S131564. eCollection 2017.

Poor 1st-year adherence to anti-osteoporotic therapy increases the risk of mortality in patients with magnetic resonance imaging-proven acute osteoporotic vertebral fractures

Ying-Chou Chen  1 , Wei-Che Lin  2
Affiliations

Poor 1st-year adherence to anti-osteoporotic therapy increases the risk of mortality in patients with magnetic resonance imaging-proven acute osteoporotic vertebral fractures

Ying-Chou Chen et al. Patient Prefer Adherence. .

Abstract

Aim: Anti-osteoporotic therapy requires years of proper compliance to reduce the risk of fractures. This study investigated the effects of 1st-year adherence to anti-osteoporotic treatment on the risk of mortality in patients with magnetic resonance imaging-proven acute osteoporotic vertebral fractures after vertebroplasty.

Patients and methods: This retrospective study included 294 patients (252 females; mean age, 73.93±7.18 years) with osteoporosis and acute vertebral fractures treated with vertebroplasty between January 2001 and December 2007. Sex, age, body mass index, comorbidities, previous hip fracture, number of vertebral fractures, 5-year re-fracture rate, and use of anti-osteoporotic therapy were recorded for each patient. Adherence was determined according to compliance and persistence for 1 year. Compliance was calculated as the medication possession ratio (MPR), and persistence as the time from treatment initiation to discontinuation. Poor adherence was defined as either non-compliance or non-persistence.

Results: The MPR of the patients at 1 year was 55.1%, with a persistence rate of 69.4% and a poor adherence rate of 62.6%. Cox regression analysis revealed that poor adherence to medications was associated with a significantly higher risk of mortality after adjustment for potential confounders (hazard ratio [HR]: 1.75; 95% CI: 1.13-2.71). Poor adherence to medications was significantly associated with an increase in the rate of infection (HR: 4.56; 95% CI: 1.12-18.52), which was the most common cause of death.

Conclusion: Poor adherence to anti-osteoporotic therapy significantly increases the risk of morality, possibly due to an increased risk of infection. Efforts should be made to improve adherence.

Keywords: adherence; mortality; osteoporosis; vertebral fracture.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves for the adherence (blue line) and poor adherence (green line). Note: The poor adhesion group had a lower survival than the adherence group.
See this image and copyright information in PMC

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