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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2023

01-12-2023 | Osteoporosis | Original Article

Investigating the impact of a national educational program on patient adherence to osteoporosis medications

Authors: Thu Vuong, Matthew Peters, Alistair Merrifield, Marnie Firipis, Josephine Belcher, Zain Elgebaly

Published in: Archives of Osteoporosis | Issue 1/2023

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Abstract

Summary

Interrupted time series analysis (ITS) measured improvements in osteoporosis medication adherence after a national education program. The proportion of patients who were adherent to treatment increased following the program.

Introduction

The NPS MedicineWise osteoporosis program, implemented nationally in 2015–2016 in Australia, sought to improve adherence to osteoporosis medicines using evidence-based multifaceted large-scale educational interventions targeting general practitioners.

Methods

We undertook a retrospective, observational study using ITS analysis from 1 December 2011 to 31 December 2019 using a 10% sample of Pharmaceutical Benefits Scheme (PBS) dispensing data for 71,093 patients ≥ 45 years. The adherence measure was the percentage of patients with a proportion of days covered (PDC) ≥ 80%.

Results

The program significantly increased adherence to osteoporosis medicines. After 12 months, the estimated adherence rate with the program was 48.4% (95% CI, 47.4–49.4%). Without the program, adherence would have fallen to 43.5% (95% CI, 42.5–44.5%). There was a further increase in adherence by the end of the study period (44 months after the program). Among patients prescribed denosumab only, despite a significant increase in adherence following the program, adherence rates were overall sub-optimal (65.0% 12 months following the program).

Conclusions

The NPS MedicineWise osteoporosis program significantly increased osteoporosis medicine adherence. The program changed primary care prescriber behavior and improved treatment adherence. However, some patients had a period of treatment discontinuation, placing them at increased risk of fracture. A focused program emphasizing the importance of long-term adherence with denosumab (including switching to bisphosphonates if treatment is discontinued) may be warranted to further improve the quality use of osteoporosis treatment in Australia.
Appendix
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Metadata
Title
Investigating the impact of a national educational program on patient adherence to osteoporosis medications
Authors
Thu Vuong
Matthew Peters
Alistair Merrifield
Marnie Firipis
Josephine Belcher
Zain Elgebaly
Publication date
01-12-2023
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2023
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-023-01301-2

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