Améliorer la prévention secondaire et l'adhésion thérapeutique chez les patients atteints d'ostéoporose
Osteoporosis is a silent disease, which leads to increased bone fragility and non traumatic fractures. The diagnosis of osteoporosis and of an increased risk of fracture can be made upon several risk factors and the measure of bone mineral density (BMD). Though it is recognized as a public health problem regarding consequent disability and costs, its prevention is neglected. BMD is too rarely prescribed to screen individuals at high risk and even after a diagnosis of low BMD has been made, less than 20% of patients are appropriately treated. We performed a qualitative study to better understand the barriers of the general practitioners regarding antiosteoporotic treatments prescriptions.
Merle B, Dupraz C, Haesebaert J, Barraud L, Aussedat M, Motteau C, Simon V, Schott AM, Flori M. Osteoporosis prevention: where are the barriers to improvement in a French general population? A qualitative study. Osteoporos Int. 2018 Oct 10.
Some studies have suggested that treatment adherence and persistence might be decreased with some generic versus brand antiosteoporotic medications. We conducted a study within the EGB database. During the 7-year inclusion period, 6,612 patients initiated an oral bisphosphonates (BP) treatment for primary OP, in the multivariate analyses,, treatment initiation with brand oral BP was associated with a lower 1-year persistence (OR=0.54; 95% CI=[0.43;0.69]) but was not associated with good implementation.
We did not find any evidence to support the hypothesis of a lower adherence with generic BPs. Conversely, in multivariate analysis, there was a significantly better 1-year persistence of generic BPs versus brand
Viprey, M., Xue, Y., Rousseau, A., Abbas, F., Dima, A., Schott A. M. (2018 juillet) Persistence with brand versus generic oral bisphosphonates among newly treated osteoporosis patients : a retrospective cohort study in the french claims database. Communication Euroepi 2018