Table 4.
Predictors of Nonadherence to Bone Mineral Density Screening at 26 and 38 Months in Univariate Modified Poisson Model
| |
26 months |
38 months |
||
|---|---|---|---|---|
| IRR | 95% CI | IRR | 95% CI | |
| Age at AI start, years | ||||
| <65 | Reference | Reference | ||
| ≥65 | 1.08 | (0.76-1.53) | 0.98 | (0.80-1.20) |
| Race | ||||
| Caucasian | Reference | Reference | ||
| African American | 1.40 | (0.69-2.88) | 1.09 | (0.70-1.71) |
| American Indian/Alaskan Native | 0.70 | (0.21-2.37) | 1.17 | (0.85-1.61) |
| Asian | 1.40 | (0.83-2.37) | 0.91 | (0.57-1.46) |
| Education | ||||
| High school graduate or less | Reference | Reference | ||
| Some college | 0.89 | (0.58-1.36) | 1.15 | (0.82-1.62) |
| College graduate | 0.90 | (0.55-1.47) | 1.03 | (0.70-1.53) |
| Postcollege | 0.43 | (0.23-0.80) | 1.09 | (0.76-1.57) |
| Missing | 0.76 | (0.45-1.26) | 1.16 | (0.82-1.64) |
| Weight, kg | ||||
| ≥70 | Reference | Reference | ||
| <70 | 0.85 | (0.61-1.20) | 0.94 | (0.78-1.14) |
| Smoking status | ||||
| Current | Reference | Reference | ||
| Past | 0.65 | (0.38-1.11) | 1.02 | (0.75-1.40) |
| Never | 0.55 | (0.34-0.89) | 0.86 | (0.64-1.16) |
| Insurance type | ||||
| Medicare | Reference | Reference | ||
| Individual | 1.08 | (0.63-1.85) | 1.02 | (0.73-1.44) |
| Commercial | 1.06 | (0.52-2.16) | 1.06 | (0.74-1.53) |
| Primary care clinic geographic region | ||||
| Region 1 | Reference | Reference | ||
| Region 2 | 0.41 | (0.25-0.68) | (0.48 | (0.36-0.65) |
| Region 3 | 1.28 | (0.76-2.14) | 0.79 | (0.54-1.14) |
| Region 4 | 1.28 | (0.76-2.14) | 0.86 | (0.70-1.06) |
| Charlson comorbidity score13 | ||||
| 0 | Reference | Reference | ||
| 1+ | 1.29 | (0.92-1.83) | 1.09 | (0.90-1.32) |
| History of fracture | ||||
| No | Reference | Reference | ||
| Yes | 0.84 | (0.50-1.41) | 1.12 | (0.89-1.40) |
| Diabetes mellitus | ||||
| No | Reference | Reference | ||
| Yes | 1.56 | (1.13-2.15) | 1.13 | (0.94-1.36) |
| Depression | ||||
| No | Reference | Reference | ||
| Yes | 0.97 | (0.62-1.51) | 1.10 | (0.89-1.35) |
| Any medical conditions associated with osteoporosis (AppendixA) | ||||
| No | Reference | Reference | ||
| Yes | 0.77 | (0.33-1.79) | 0.60 | (0.31-1.16) |
| Corticosteroid use | ||||
| No | Reference | Reference | ||
| Yes | 0.84 | (0.53-1.35) | 1.26 | (1.07-1.48) |
| Use of other medications associated with risk of osteoporosis (AppendixA) | ||||
| No | Reference | Reference | ||
| Yes | 1.10 | (0.75-1.62) | 1.15 | (0.96-1.37) |
| Breast cancer stage | ||||
| I | Reference | Reference | ||
| IIA | 0.96 | (0.65-1.42) | 1.00 | (0.81-1.23) |
| IIB | 1.15 | (0.78-1.70) | 1.02 | (0.82-1.28) |
| Time from incident breast cancer diagnosis to AI start, years | ||||
| ≤1 | Reference | Reference | ||
| >1–3 | 1.31 | (0.85-2.02) | 1.05 | (0.83-1.32) |
| >3–5 | 1.22 | (0.74-2.02) | 0.87 | (0.60-1.27) |
| >5–16 | 1.36 | (0.89-2.06) | 0.87 | (0.69-1.11) |
| AI start year | ||||
| 2004 | Reference | Reference | ||
| 2005 | 1.41 | (0.88-2.27) | 1.07 | (0.85-1.35) |
| 2006 | 1.30 | (0.79-2.13) | 1.07 | (0.84-1.36) |
| 2007 | 0.63 | (0.21-1.90) | 0.82 | (0.49-1.37) |
| Predominant AI type used | ||||
| Anastrozole | Reference | Reference | ||
| Exemestane | 1.99 | (1.34-2.97) | 1.30 | (1.17-1.45) |
| Letrozole | 1.13 | (0.78-1.62) | 0.87 | (0.71-1.06) |
| BMD w/in 1 year of AI start | ||||
| No | Reference | Reference | ||
| Yes | 1.47 | (1.02-2.11) | 1.36 | (1.19-1.56) |
| Tamoxifen use since breast cancer diagnosis | ||||
| No TAM use | Reference | Reference | ||
| TAM use before AI start | 1.40 | (0.98-2.00) | 0.96 | (0.80-1.16) |
| TAM use after AI | 0.41 | (0.06-2.66) | 1.35 | (1.19-1.53) |
| Number of visits to oncologist in year before AI start | ||||
| 0 | Reference | Reference | ||
| 1–2 | 1.64 | (0.87-3.08) | 1.44 | (0.95-2.16) |
| 3–4 | 1.13 | (0.54-2.38) | 1.52 | (0.97-2.37) |
| ≥5 | 1.42 | (0.71-2.87) | 1.78 | (1.19-2.65) |
CI, confidence interval; IRR, incidence rate ratio.