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英国普通实践研究数据库中绝经后妇女骨质疏松症药物的坚持情况。

Persistence with osteoporosis medications among postmenopausal women in the UK General Practice Research Database.

机构信息

The Boston Collaborative Drug Surveillance Program, Lexington, MA 02421, USA.

出版信息

Menopause. 2012 Jan;19(1):33-40. doi: 10.1097/gme.0b013e318221bacd.

Abstract

OBJECTIVE

The aims of this study were to estimate persistence with osteoporosis therapies and to assess persistence by different users (stable and switching), type of osteoporosis drug, and calendar year of initiation among postmenopausal women.

METHODS

This study was conducted using the data from the UK General Practice Research Database. We identified all women in the General Practice Research Database who had a first-ever recording of a prescription for an oral bisphosphonate, oral raloxifene, or oral strontium ranelate between January 1, 1995, and March 31, 2008, and who were 50 years or older or had a diagnosis to indicate menopause at an earlier age.Persistence was estimated as the proportion of women who continued therapy at 6 months and at 1, 3, and 5 years, using Kaplan-Meier methodology. Because women could have multiple episodes (of one or more therapies) over the follow-up period, persistence was evaluated for each individual episode.

RESULTS

There were 66,116 eligible postmenopausal women who received at least one prescription for one of the osteoporosis therapy drugs in this study during the period 1995 to 2008. Overall, the women were continuing with osteoporosis therapy at 6 months after the index date in the full study population in 44% of episodes and in 32%, 16%, and 9% of episodes at 1, 3, and 5 years later, respectively.

CONCLUSIONS

Persistence with osteoporosis therapies has improved over the study period, but persistence in the first 6 months remains below 50%, leaving a large unmet need to improve the management of postmenopausal women through novel adherence programs and therapies.

摘要

目的

本研究旨在评估骨质疏松症治疗的持续率,并评估不同使用者(稳定和转换)、骨质疏松症药物类型和起始日历年份对绝经后妇女的持续率。

方法

本研究使用了英国普通实践研究数据库的数据。我们确定了所有在 1995 年 1 月 1 日至 2008 年 3 月 31 日期间首次记录有口服双膦酸盐、口服雷洛昔芬或口服雷奈酸锶处方的普通实践研究数据库中 50 岁或以上或有更早绝经诊断的女性。使用 Kaplan-Meier 方法估计 6 个月和 1、3 和 5 年时的女性持续治疗的比例。由于女性在随访期间可能有多个疗程(一种或多种治疗),因此对每个疗程进行了持续治疗的评估。

结果

在 1995 年至 2008 年期间,共有 66116 名符合条件的绝经后女性接受了至少一种骨质疏松症治疗药物的处方。总体而言,在全研究人群中,有 44%的疗程在索引日期后 6 个月时继续接受骨质疏松症治疗,在 1 年、3 年和 5 年后,分别有 32%、16%和 9%的疗程继续接受治疗。

结论

随着研究时间的推移,骨质疏松症治疗的持续率有所提高,但在最初的 6 个月内,持续率仍低于 50%,这表明需要通过新的依从性方案和治疗方法来改善绝经后妇女的管理,以满足大量未满足的需求。

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