May 1, 2013
Many Bisphosphonate Prescriptions Never Filled
for Osteoporosis

Pasadena, CA—Pharmacists may never have the opportunity to fill prescriptions for bisphosphonate therapy for nearly 30% of women prescribed the treatment for osteoporosis and similar bone diseases.

That’s according to researchers from Kaiser Permanente, who warned that primary nonadherence to treatment could lead to an increased risk of fractures for these patients.

The study, published in the journal Osteoporosis International, examined the electronic health records of 8,454 women, ages 55 years or older, who were Kaiser Permanente Southern California members between December 2009 and March 2011 and were prescribed a new bisphosphonate medication. Failing to pick up their prescription within 60 days of the order date were 29.5% of patients, particularly those who were older and had used the emergency department in the last year.

Those more likely to fill their prescriptions included women taking other prescription medications and those who had been hospitalized in the prior year, according to the researchers. Other factors affecting medication adherence were the prescriber’s specialty: Women were more likely to fill their prescription if ordered by rheumatology or internal medicine specialists than other primary care physicians. The length of time the prescribing physician had practiced was also a factor: Those receiving a bisphosphonate prescription from a physician practicing 10 or more years at Kaiser Permanente were more likely to pick up their medication than those getting a script from a doctor with shorter tenure.

“Although bisphosphonates have been proven to reduce the risk of osteoporotic fracture, low adherence to these medications is common, which contributes to serious and costly health problems,” said lead author Kristi Reynolds, PhD, MPH, a research scientist at Kaiser Permanente. “This study simultaneously examined patient and prescribing provider characteristics and helped identify certain factors associated with why patients failed to pick up their new prescriptions.”

This is the latest in a series of studies from Kaiser Permanente on medication nonadherence. A report late last year found that patients newly prescribed a cholesterol-lowering medication were more likely to pick it up from the pharmacy if they received automated phone and mail reminders.

According to Kaiser Permanente, medication nonadherence contributes to approximately 125,000 deaths in the United States and costs the health care system $290 billion. In fact, the group noted, one in three patients prescribed a medication by their health care provider never pick it up from the pharmacy, and three out of four Americans do not take prescription drugs according to providers’ orders even when they pick them up.

“These findings suggest that health care providers must do a better job of identifying barriers and developing interventions that address the individual patient's needs and concerns at the time the prescription is ordered,” Reynolds said. ‘The use of electronic health records, like the system in place at Kaiser Permanente, has helped us better understand and address primary non-adherence, which has historically been difficult to identify.”

U.S. Pharmacist Social Connect