Duarte Jesús Walliser, Bolge Susan C, Sen Shuvayu S
Clínica de Metabolismo Oseo y Mineral del Hospital Angeles del Pedregal, Mexico City, Mexico.
Clin Ther. 2007 Mar;29(3):488-503. doi: 10.1016/s0149-2918(07)80087-7.
Patients' preferences for medications may be important in determining their compliance with therapy, particularly in the case of an asymptomatic chronic disease such as osteoporosis. Although preferences for certain attributes of osteoporosis medications, including dosing frequency and tolerability, can be evaluated in short-term clinical trials, years of use may be necessary for differences in effectiveness in reducing fracture risk to emerge.
The primary aim of this study was to evaluate the relative importance of various attributes in determining patients' preferences for osteoporosis medications. Its secondary aim was to investigate patients' preferences for either of 2 hypothetical osteoporosis medications with different profiles.
The Preference for Effective Regimens (PREFER)-International study was a cross-sectional survey of postmenopausal women with osteoporosis in France, Germany, Mexico, Spain, and the United Kingdom. Participants were recruited by their physicians in the 4 European countries and were identified by trained interviewers going door to door in Mexico. Participants were administered a questionnaire in which they were asked to rate and rank the importance of 7 medication attributes in determining their preferences for prescription osteoporosis medications. The attributes were side effects, out-of-pocket costs, effectiveness in improving bone health and preventing fractures, dosing frequency, formulation, administration procedure, and length of time on the market. They were also asked to indicate their preference for 2 hypothetical osteoporosis medications whose profiles differed in terms of efficacy (medication A reduced the risk of spine and hip fracture; medication B reduced spine fracture only), time on the market (10 years vs recently introduced), dosing frequency (weekly vs monthly), and dosing procedure (30- vs 60-minute wait after dosing).
Of 3000 patients interviewed, 1500 were receiving prescription treatment for osteoporosis. Across the rankings and ratings, effectiveness in reducing the risk of fracture emerged as the most important factor in determining patients' preferences for prescription osteoporosis medications, followed by side effects. Out-of-pocket costs, dosing frequency, formulation, time on the market, and dosing procedure were less important considerations among respondents from most countries. The majority (78%) of patients indicated a preference for medication A over medication B.
Effectiveness in reducing fracture risk was cited as the primary reason for patients' preference for prescription osteoporosis medications among postmenopausal women with osteoporosis from 4 European countries and Mexico.
患者对药物的偏好可能对确定其治疗依从性很重要，尤其是在骨质疏松症这种无症状慢性疾病的情况下。虽然骨质疏松症药物某些属性（包括给药频率和耐受性）的偏好可在短期临床试验中进行评估，但可能需要数年的使用时间才能显现出在降低骨折风险有效性方面的差异。
本研究的主要目的是评估各种属性在确定患者对骨质疏松症药物偏好方面的相对重要性。其次要目的是调查患者对两种不同特征的假设性骨质疏松症药物的偏好。
有效治疗方案偏好（PREFER）国际研究是一项对法国、德国、墨西哥、西班牙和英国绝经后骨质疏松症女性进行的横断面调查。在4个欧洲国家，参与者由其医生招募，在墨西哥由经过培训的访员挨家挨户识别。参与者接受了一份问卷，其中要求他们对7种药物属性在确定其对处方骨质疏松症药物偏好方面的重要性进行评分和排序。这些属性包括副作用、自付费用、改善骨骼健康和预防骨折的有效性、给药频率、剂型、给药程序以及上市时间。他们还被要求表明对两种假设性骨质疏松症药物的偏好，这两种药物在疗效（药物A降低脊柱和髋部骨折风险；药物B仅降低脊柱骨折风险）、上市时间（10年与最近推出）、给药频率（每周与每月）和给药程序（给药后等待30分钟与60分钟）方面有所不同。
在接受访谈的3000名患者中，1500名正在接受骨质疏松症的处方治疗。在所有的排序和评分中，降低骨折风险的有效性成为确定患者对处方骨质疏松症药物偏好的最重要因素，其次是副作用。自付费用、给药频率、剂型、上市时间和给药程序在大多数国家的受访者中是不太重要的考虑因素。大多数（78%）患者表示更喜欢药物A而非药物B。
在来自4个欧洲国家和墨西哥的绝经后骨质疏松症女性中，降低骨折风险的有效性被认为是患者对处方骨质疏松症药物偏好的主要原因。
