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Osteoporosis International

Published in:

01-11-2013 | Original Article

Adherence to raloxifene therapy: assessment methods and relationship with efficacy

Authors: J. Finigan, K. Naylor, M. A. Paggiosi, N. F. Peel, R. Eastell

Published in: Osteoporosis International | Issue 11/2013

Abstract

Summary

Response to therapy depends on patient compliance but accurate assessment is difficult and adequate levels of adherence are uncertain. Adherence to raloxifene treatment may be assessed more accurately by electronic monitoring than by counting returned tablets. The level of adherence is positively associated with the degree of bone response.

Introduction

Adherence to study medication is usually estimated by counting returned tablets. This method relies on subjects’ honesty and may be inaccurate. We aimed to assess adherence more accurately, and examine its effect on measures of bone response, by using electronic monitoring.

Methods

Osteopenic women, ages 50 to 80, were prescribed daily raloxifene for 2 years. Electronic bottle caps (Medication Event Monitoring System (MEMS), Aardex) recorded the date and time on opening. Returned tablets were also counted. We measured bone mineral density (BMD) in duplicate at the spine and hip at baseline and 2 years. We also measured urinary N-terminal cross-linked telopeptide of type I collagen (NTX) at baseline, 1 and 2 years. We calculated the percentage changes in BMD and NTX from mean baseline to mean follow up measurements. Percentage adherence was assessed by both methods for 71 subjects that completed the study.

Results

The two methods correlated significantly (p <0.001, Spearman’s rho = 0.73) but the tablet count showed a higher median adherence than the MEMS caps (95.7 vs. 85.0 %, p <0.001), with greater divergence at lower adherence levels. MEMS adherence in 65 subjects with complete data correlated with NTX response (p <0.01, rho = −0.33) but with BMD response only at the femoral neck. However, adherence in the lowest quartile was associated with poorer BMD response at all sites (p <0.05).

Conclusion

Tablet counts may give similar results overall but conceal substantial individual non-adherence. Monitoring caps may assess adherence more accurately than tablet counts and would be the preferred method in clinical trials. The degree of adherence is associated with both bone turnover and BMD responses to anti-resorptive therapy.

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Title: Adherence to raloxifene therapy: assessment methods and relationship with efficacy
Authors: J. Finigan
K. Naylor
M. A. Paggiosi
N. F. Peel
R. Eastell
Publication date: 01-11-2013
Publisher: Springer London
Published in: Osteoporosis International / Issue 11/2013
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-013-2386-6

ACC 2024 Congress

Springer Medicine

Adherence to raloxifene therapy: assessment methods and relationship with efficacy

Abstract

Summary

Introduction

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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