Conference Paper: Factors associated with osteoporosis treatment adherence in Hong Kong

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- Dr Wu, Joseph Tsz Kei
- Professor Kung, Annie Wai Chee

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Title	Factors associated with osteoporosis treatment adherence in Hong Kong
Authors	Soong, CSS Loong, CHN Bow, CHY Wu, JTK Kung, AWC
Issue Date	2010
Citation	The 11th Regional Osteoporosis Conference (ROC), Hong Kong, 15-16 May 2010. [How to Cite?]
Abstract	Introduction: Effective prevention of osteoporotic fracture requires long term adherence to osteoporosis medication. Longitudinal studies revealed that more than 60% of patients terminated their treatment at one year and the problem increases with time. The problem of non-adherence to osteoporosis medication in Hong Kong is unclear. Objective: To assess patient adherence to osteoporosis medication in Hong Kong and to identify the associating factors for nonadherence. Method: 244 patients attended the osteoporosis clinic in Queen Mary Hospital for the first time between January 2007 and December 2008 were invited to participate in a retrospective observational study for their adherence to treatment. Baseline clinical and demographic information, bone mineral density, lifestyle risk factors were assessed by medical charts review. Details in treatment adherence, acceptance, incident fractures, hospital admission and mobility level were collected by telephone interviews. Information were verified from the Hospital Authority Electronic Patient Record System. Medication compliance was measured by proportion of days covered (PDC). A patient is considered as a complier if he/she had missed < 20% of the proportion of days covered (PDC). Results: A total of 193 patients participated in this study with 79.1 % response rate. The mean rate of medication adherence was 75.3% (PDC) after a mean follow up of 2.3 years. The rate of medication adherence decreased progressively with follow up duration (PDC: 74.5% at first year, 75.6% at second year, 63.7% at third year). The risk factors for non-adherence to treatment were self-perceived having too many medications (OR: 19.77, 95% CI: 2.41-161.99, p<0.001); self-perceived adverse effect from medication (OR: 16.98, 95% CI: 2.04-141.35, p=0.001); self-perceived cannot afford the medication (OR: 14.29, 95% CI: 1.68-121.5, p=0.004); self-perceived not requiring the medication (OR: 9.53, 95% CI: 2.99-30.42, p <0.001); bedbound (OR: 9.19, 95% CI: 1.00-84.08, p=0.035); smoking (OR: 3.97, 95% CI: 1.23-12.76, p=0.025); unsatisfied with medication (OR: 3.17, 95% CI: 1.05-9.59, p=0.04) and medication adverse effect (OR: 1.15, 95% CI: 1.04-1.27, p<0.001). Conclusion: Although the rate of non-adherence in our study was lower than reported by overseas studies, the problem exacerbated with longer treatment duration. Several self-perceived factors were found associated with patient non-adherence. This study identified the common misconceptions and concerns about osteoporosis medications among patients that required long term treatment. To lower the non-adherence rate, doctors should improve their communications with patients to resolve their concerns with long term medical therapy.
Description	Poster presentations: Poster 6 Regional Osteoporosis Conference

DC Field	Value
dc.contributor.author	Soong, CSS
dc.contributor.author	Loong, CHN
dc.contributor.author	Bow, CHY
dc.contributor.author	Wu, JTK
dc.contributor.author	Kung, AWC
dc.date.accessioned	2010-10-31T12:29:36Z
dc.date.available	2010-10-31T12:29:36Z
dc.date.issued	2010
dc.description.abstract	Introduction: Effective prevention of osteoporotic fracture requires long term adherence to osteoporosis medication. Longitudinal studies revealed that more than 60% of patients terminated their treatment at one year and the problem increases with time. The problem of non-adherence to osteoporosis medication in Hong Kong is unclear. Objective: To assess patient adherence to osteoporosis medication in Hong Kong and to identify the associating factors for nonadherence. Method: 244 patients attended the osteoporosis clinic in Queen Mary Hospital for the first time between January 2007 and December 2008 were invited to participate in a retrospective observational study for their adherence to treatment. Baseline clinical and demographic information, bone mineral density, lifestyle risk factors were assessed by medical charts review. Details in treatment adherence, acceptance, incident fractures, hospital admission and mobility level were collected by telephone interviews. Information were verified from the Hospital Authority Electronic Patient Record System. Medication compliance was measured by proportion of days covered (PDC). A patient is considered as a complier if he/she had missed < 20% of the proportion of days covered (PDC). Results: A total of 193 patients participated in this study with 79.1 % response rate. The mean rate of medication adherence was 75.3% (PDC) after a mean follow up of 2.3 years. The rate of medication adherence decreased progressively with follow up duration (PDC: 74.5% at first year, 75.6% at second year, 63.7% at third year). The risk factors for non-adherence to treatment were self-perceived having too many medications (OR: 19.77, 95% CI: 2.41-161.99, p<0.001); self-perceived adverse effect from medication (OR: 16.98, 95% CI: 2.04-141.35, p=0.001); self-perceived cannot afford the medication (OR: 14.29, 95% CI: 1.68-121.5, p=0.004); self-perceived not requiring the medication (OR: 9.53, 95% CI: 2.99-30.42, p <0.001); bedbound (OR: 9.19, 95% CI: 1.00-84.08, p=0.035); smoking (OR: 3.97, 95% CI: 1.23-12.76, p=0.025); unsatisfied with medication (OR: 3.17, 95% CI: 1.05-9.59, p=0.04) and medication adverse effect (OR: 1.15, 95% CI: 1.04-1.27, p<0.001). Conclusion: Although the rate of non-adherence in our study was lower than reported by overseas studies, the problem exacerbated with longer treatment duration. Several self-perceived factors were found associated with patient non-adherence. This study identified the common misconceptions and concerns about osteoporosis medications among patients that required long term treatment. To lower the non-adherence rate, doctors should improve their communications with patients to resolve their concerns with long term medical therapy.
dc.description	Poster presentations: Poster 6
dc.description	Regional Osteoporosis Conference
dc.description.other	The 11th Regional Osteoporosis Conference (ROC), Hong Kong, 15-16 May 2010.
dc.identifier.citation	The 11th Regional Osteoporosis Conference (ROC), Hong Kong, 15-16 May 2010. [How to Cite?]
dc.identifier.hkuros	175029
dc.identifier.uri	http://hdl.handle.net/10722/126456
dc.language	eng
dc.title	Factors associated with osteoporosis treatment adherence in Hong Kong
dc.type	Conference_Paper

<?xml encoding="utf-8" version="1.0"?><item><contributor.author>Soong, CSS</contributor.author><contributor.author>Loong, CHN</contributor.author><contributor.author>Bow, CHY</contributor.author><contributor.author>Wu, JTK</contributor.author><contributor.author>Kung, AWC</contributor.author><date.accessioned>2010-10-31T12:29:36Z</date.accessioned><date.available>2010-10-31T12:29:36Z</date.available><date.issued>2010</date.issued><identifier.citation>The 11th Regional Osteoporosis Conference (ROC), Hong Kong, 15-16 May 2010.</identifier.citation><identifier.uri>http://hdl.handle.net/10722/126456</identifier.uri><description>Poster presentations: Poster 6</description><description>Regional Osteoporosis Conference</description><description.abstract>Introduction: Effective prevention of osteoporotic fracture requires long term adherence to osteoporosis medication. Longitudinal studies revealed that more than 60% of patients terminated their treatment at one year and the problem increases with time. The problem of non-adherence to osteoporosis medication in Hong Kong is unclear. Objective: To assess patient adherence to osteoporosis medication in Hong Kong and to identify the associating factors for nonadherence. Method: 244 patients attended the osteoporosis clinic in Queen Mary Hospital for the first time between January 2007 and December 2008 were invited to participate in a retrospective observational study for their adherence to treatment. Baseline clinical and demographic information, bone mineral density, lifestyle risk factors were assessed by medical charts review. Details in treatment adherence, acceptance, incident fractures, hospital admission and mobility level were collected by telephone interviews. Information were verified from the Hospital Authority Electronic Patient Record System. Medication compliance was measured by proportion of days covered (PDC). A patient is considered as a complier if he/she had missed &lt; 20% of the proportion of days covered (PDC). Results: A total of 193 patients participated in this study with 79.1 % response rate. The mean rate of medication adherence was 75.3% (PDC) after a mean follow up of 2.3 years. The rate of medication adherence decreased progressively with follow up duration (PDC: 74.5% at first year, 75.6% at second year, 63.7% at third year). The risk factors for non-adherence to treatment were self-perceived having too many medications (OR: 19.77, 95% CI: 2.41-161.99, p&lt;0.001); self-perceived adverse effect from medication (OR: 16.98, 95% CI: 2.04-141.35, p=0.001); self-perceived cannot afford the medication (OR: 14.29, 95% CI: 1.68-121.5, p=0.004); self-perceived not requiring the medication (OR: 9.53, 95% CI: 2.99-30.42, p &lt;0.001); bedbound (OR: 9.19, 95% CI: 1.00-84.08, p=0.035); smoking (OR: 3.97, 95% CI: 1.23-12.76, p=0.025); unsatisfied with medication (OR: 3.17, 95% CI: 1.05-9.59, p=0.04) and medication adverse effect (OR: 1.15, 95% CI: 1.04-1.27, p&lt;0.001). Conclusion: Although the rate of non-adherence in our study was lower than reported by overseas studies, the problem exacerbated with longer treatment duration. Several self-perceived factors were found associated with patient non-adherence. This study identified the common misconceptions and concerns about osteoporosis medications among patients that required long term treatment. To lower the non-adherence rate, doctors should improve their communications with patients to resolve their concerns with long term medical therapy.</description.abstract><language>eng</language><title>Factors associated with osteoporosis treatment adherence in Hong Kong</title><type>Conference_Paper</type><identifier.hkuros>175029</identifier.hkuros><description.other>The 11th Regional Osteoporosis Conference (ROC), Hong Kong, 15-16 May 2010.</description.other></item>

Conference Paper: Factors associated with osteoporosis treatment adherence in Hong Kong

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