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Extent of and reasons for osteoporosis medication non-adherence among veterans and feasibility of a pilot text message reminder intervention

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Abstract

Summary

We determined the extent of and reasons for non-adherence to oral bisphosphonates among veterans and conducted a pilot text message reminder application aimed at the most commonly cited reason for non-adherence. The intervention was found to be acceptable and feasible.

Purpose

To evaluate the extent of and reasons for non-adherence to oral bisphosphonates among veterans and to assess the acceptability and feasibility of a pilot text message reminder application.

Methods

We surveyed 105 veterans initiating oral bisphosphonates for osteoporosis/osteopenia within the prior 18 months utilizing a validated self-report measure adapted for osteoporosis. Additionally, we conducted a pilot text message reminder to determine feasibility in 12 veterans who were initiating or were currently non-adherent to oral bisphosphonates.

Results

Of the 43 (40.9% response rate) completed surveys, the most common reasons for non-adherence were “I forgot” (37.5%), “I had other medications to take” (20.5%), “my bones are not weak” (18.4%), “I felt well” (18.4%), and “I worried about taking them for the rest of my life” (17.9%). Median MPR for the 49 (46.7%) non-adherent (MPR < 0.80) veterans was 0.35 (IQR 0.21–0.64). Of veterans offered a weekly automated text message reminder, 12 (50%) accepted. Nine of these 12 veterans reported that the text message reminders did “very well” at reminding them to take their medication and would recommend the application to other patients/family/friends. The median 6-month MPR for the reminder group was 0.96 (IQR 0.54–1.00).

Conclusion

Half the veterans in our sample were taking insufficient doses of oral bisphosphonates to attain the full benefit of fracture risk reduction. Reasons for poor adherence included forgetfulness, polypharmacy, and misconceptions about osteoporosis. A pilot text message reminder intervention targeted to one of the most commonly cited reasons was found to be acceptable and feasible among veterans.

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References

  1. Cranney A, Guyatt G, Griffith L, Wells G, Tugwell P, Rosen C, The Osteoporosis Methodology Group, The Osteoporosis Research Advisory Group (2002) Meta-analyses of therapies for postmenopausal osteoporosis. IX: Summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev 23(4):570–578

    Article  CAS  Google Scholar 

  2. Nayak S, Greenspan SL (2017) Osteoporosis treatment efficacy for men: a systematic review and meta-analysis. J Am Geriatr Soc 65(3):490–495

    Article  Google Scholar 

  3. Fardellone P, Lello S, Cano A, de Sá Moreira E, Watanabe de Oliveira R, Julian GS, Tang B (2019) Real-world adherence and persistence with bisphosphonate therapy in postmenopausal women: a systematic review. Clin Ther 41(8):1576–1588

    Article  CAS  Google Scholar 

  4. Voils CI, Maciejewski ML, Hoyle RH, Reeve BB, Gallagher P, Bryson CL, Yancy WS Jr (2012) Initial validation of a self-report measure of the extent of and reasons for medication nonadherence. Med Care 50(12):1013–1019

    Article  Google Scholar 

  5. Jaleel A, Saag KG, Danila MI (2018) Improving drug adherence in osteoporosis: an update on more recent studies. Ther Adv Musculoskelet Dis 10(7):141–149

    Article  Google Scholar 

  6. Hiligsmann M, Salas M, Hughes DA, Manias E, Gwadry-Sridhar FH, Linck P, Cowell W (2013) Interventions to improve osteoporosis medication adherence and persistence: a systematic review and literature appraisal by the ISPOR Medication Adherence & Persistence Special Interest Group. Osteoporos Int 24(12):2907–2918

    Article  CAS  Google Scholar 

  7. Patrick AR, Brookhart MA, Losina E, Schousboe JT, Cadarette SM, Mogun H, Solomon DH (2010) The complex relation between bisphosphonate adherence and fracture reduction. J Clin Endocrinol Metab 95(7):3251–3259

    Article  CAS  Google Scholar 

  8. Siris ES, Harris ST, Rosen CJ, Barr CE, Arvesen JN, Abbott TA, Silverman S (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81(8):1013–1022

    Article  Google Scholar 

  9. Blalock DV, Zullig LL, Bosworth HB, Taylor SS, Voils CI (2019) Self-reported medication nonadherence predicts cholesterol levels over time. J Psychosom Res 118:49–55

    Article  Google Scholar 

  10. Voils CI, King HA, Thorpe CT, Blalock DV, Kronish IM, Reeve BB, Boatright C, Gellad ZF (2019) Content validity and reliability of a self-report measure of medication nonadherence in hepatitis C treatment. Dig Dis Sci 64(10):2784–2797

    Article  Google Scholar 

  11. Anghel LA, Farcas AM, Oprean RN (2019) An overview of the common methods used to measure treatment adherence. Med Pharm Rep 92(2):117–122

    PubMed  PubMed Central  Google Scholar 

  12. Nho JH, Lee YK, Ha YC, Kim CH, Suh YS, Koo KH (2016) Can alarming improve compliance with weekly bisphosphonate in patients with osteoporosis? J Bone Metab 23(2):51–54

    Article  Google Scholar 

  13. Bianchi ML, Duca P, Vai S, Guglielmi G, Viti R, Battista C, Scillitani A, Muscarella S, Luisetto G, Camozzi V, Nuti R, Caffarelli C, Gonnelli S, Albanese C, de Tullio V, Isaia G, D’Amelio P, Broggi F, Croci M (2015) Improving adherence to and persistence with oral therapy of osteoporosis. Osteoporos Int 26(5):1629–1638

    Article  CAS  Google Scholar 

  14. Cornelissen D, de Kunder S, Si L, et al (2020) Interventions to improve adherence to anti-osteoporosis medications: an updated systematic review. Osteoporos Int 31(9):1645–1669. https://doi.org/10.1007/s00198-020-05378-0

  15. Ducoulombier V, Luraschi H, Forzy G et al (2015) Contribution of phone follow-up to improved adherence to oral osteoporosis treatment. Am J Pharm Benefits 7:e81–e89

    Google Scholar 

  16. van den Berg P, van Haard PMM, van der Veer E, Geusens PP, van den Bergh JP, Schweitzer DH (2018) A dedicated Fracture Liaison Service telephone program and use of bone turnover markers for evaluating 1-year persistence with oral bisphosphonates. Osteoporos Int 29(4):813–824

    Article  Google Scholar 

  17. Kannisto KA, Koivunen MH, Välimäki MA (2014) Use of mobile phone text message reminders in health care services: a narrative literature review. J Med Internet Res 16(10):e222

    Article  Google Scholar 

  18. Thakkar J, Kurup R, Laba TL, Santo K, Thiagalingam A, Rodgers A, Woodward M, Redfern J, Chow CK (2016) Mobile telephone text messaging for medication adherence in chronic disease: a meta-analysis. JAMA Intern Med 176(3):340–349

    Article  Google Scholar 

  19. Dirven T, Turner C, Thio SL, Blom J, Muth C, van Driel ML (2020) Room for improvement in reporting of trials discontinuing long-term medication: a systematic review. J Clin Epidemiol 119:65–74

    Article  Google Scholar 

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Funding

Research reported in this publication was supported by the National Institutes of Health under Award Numbers T32DK007012 (NS), I01 HX002512, and K24 AG049077 (CCE).

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Authors and Affiliations

  1. Division of Endocrinology, Department of Medicine, Duke University Medical Center, Box 3924, 200 Trent Drive, Baker House, Room 310, Durham, NC, 27710, USA

    Nicole Sagalla & Richard Lee

  2. Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham, NC, USA

    Richard Lee, Kenneth Lyles, Julie Vognsen & Cathleen Colón-Emeric

  3. Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC, USA

    Kenneth Lyles & Cathleen Colón-Emeric

Authors
  1. Nicole Sagalla
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  2. Richard Lee
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  3. Kenneth Lyles
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  4. Julie Vognsen
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  5. Cathleen Colón-Emeric
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Corresponding author

Correspondence to Nicole Sagalla.

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Conflicts of interest

Kenneth Lyles is a Trustee of the National Osteoporosis Foundation, a consultant for Health Stream, Viking, and founder and equity owner of Faculty Connection, LLC and BisCardia, Inc. Nicole Sagalla, Richard Lee, Julie Vognsen, and Cathleen Colón-Emeric declare that they have no conflict of interest.

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Sagalla, N., Lee, R., Lyles, K. et al. Extent of and reasons for osteoporosis medication non-adherence among veterans and feasibility of a pilot text message reminder intervention. Arch Osteoporos 16, 21 (2021). https://doi.org/10.1007/s11657-021-00889-7

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