Comparative adherence to weekly oral and quarterly intravenous bisphosphonates among patients with limited heath literacy who sustained distal radius fractures

• Published in: Journal of bone and mineral metabolism Vol. 36; no. 5; pp. 589 - 595
• Main Authors: Roh, Young Hak, Noh, Jung Ho, Gong, Hyun Sik, Baek, Goo Hyun
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.09.2018; Springer Nature B.V
• Subjects: Administration, Intravenous; Administration, Oral; Alendronate - administration & dosage; Alendronate - therapeutic use; Alendronic acid; Bisphosphonates; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - therapeutic use; Demography; Diphosphonates - administration & dosage; Diphosphonates - therapeutic use; Drug Administration Schedule; Female; Fractures; Health Education; Health literacy; Humans; Ibandronic Acid; Injections, Intravenous; Intravenous administration; Medication Adherence; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Multivariate Analysis; Oral administration; Original Article; Orthopedics; Osteoporosis; Osteoporosis, Postmenopausal - drug therapy; Patients; Radius Fractures - drug therapy; Trauma; Health literacy; Comparative adherence; Intravenous bisphosphonate; Oral bisphosphonate
• ISSN: 0914-8779; 1435-5604; 1435-5604
• DOI: 10.1007/s00774-017-0867-y

Individuals with limited health literacy (HL) are less likely to obtain preventive care. We designed a study to compare adherence to weekly oral and quarterly intravenous bisphosphonates among patients with low HL. The study enrolled a total of 432 female patients who presented with a distal radius fracture caused by low-energy trauma. Participant HL was measured using the Newest Vital Sign tool, and patients were randomized to weekly oral or quarterly intravenous bisphosphonate groups. Subjects in the intravenous bisphosphonate group received intravenous injections of 3 mg ibandronate every 3 months, and those in the oral bisphosphonate group self-administered 70 mg alendronate orally once each week for 12 months. The adherence to weekly oral or quarterly intravenous bisphosphonates was analyzed by HL level. The rate of adherence to quarterly intravenous bisphosphonates was significantly higher than that for weekly oral bisphosphonates in patients with inadequate HL (73 vs. 46%, p  = 0.001), whereas no significant differences were observed between HL groups in adherence to intravenous bisphosphonate. Conversely, the rate of adherence to orally administered bisphosphonates was significantly lower in patients with inadequate HL than in those with appropriate HL (46 vs. 65%, p  = 0.005). After controlling for confounding variables, inadequate HL, the presence of comorbidities, and weekly oral bisphosphonates were associated with a higher likelihood of nonadherence to osteoporosis treatment. Thus patients with limited health literacy can achieve rates of adherence to quarterly intravenous bisphosphonates, as opposed to weekly oral bisphosphonates, similar to rates among patients with appropriate literacy.