Gold Deborah T, Weinstein David L, Pohl Gerhardt, Krohn Kelly D, Chen Yi, Meadows Eric S
Departments of Psychiatry and Behavioral Sciences, Sociology, and Psychology and Neuroscience, Duke University Medical Center, Durham, NC 27710, USA.
J Osteoporos. 2011;2011:314970. doi: 10.4061/2011/314970. Epub 2011 Oct 13.
Purpose. Determine patient-reported reasons for discontinuation with teriparatide. Methods. Patients taking teriparatide in a multicenter, prospective, and observational study were given three questionnaires: baseline, follow-up questionnaire 1 (QF1, 2 to 6 months), and follow-up questionnaire 2 (QF2, 12 months). Discontinuation reported at QF1 and QF2 was defined as "early" and "late," respectively, and remaining patients were considered persistent. Cochran-Armitage trend test was used to identify factors associated with discontinuation. Results. Side effects, concern about improper use, injection difficulties, and several patient-perceived physician issues were associated with early discontinuation. Low patient-perceived importance of continuing treatment, side effects, difficulty paying, and low patient-perceived physician knowledge were associated with late discontinuation. The most common specific reasons selected for discontinuing treatment were "concerns about treatment outweighing the benefits" (n = 53) and "difficulty paying" (n = 47). Conclusions. Persistence with teriparatide is dependent on managing side effects, addressing financial challenges, proper training, and obtaining support from the healthcare provider.
目的。确定患者报告的停用特立帕肽的原因。方法。在一项多中心、前瞻性观察研究中服用特立帕肽的患者接受了三份问卷：基线问卷、随访问卷1（QF1，2至6个月）和随访问卷2（QF2，12个月）。在QF1和QF2报告的停药分别定义为“早期”和“晚期”，其余患者被视为持续用药。采用 Cochr an - Armitage趋势检验来确定与停药相关的因素。结果。副作用、对不当使用的担忧、注射困难以及一些患者感知到的医生问题与早期停药相关。患者对持续治疗的重要性感知较低、副作用、支付困难以及患者对医生知识的感知较低与晚期停药相关。选择停药的最常见具体原因是“对治疗的担忧超过益处”（n = 53）和“支付困难”（n = 47）。结论。特立帕肽的持续用药取决于控制副作用、应对经济挑战、进行适当培训以及获得医疗服务提供者的支持。
