Table 4.
Factors Associated With Restart of Any Osteoporosis Medication Among Those Who Discontinued Alendronate 1
|
N = 2185 |
|||
|---|---|---|---|
| Covariate | Hazard periodn (%) |
Control periods 1 and 2n (%) |
Adjusted OR (Wald 95% CI) |
| Factors associated with bone health | |||
| Case qualifying fragility fracture | 183 (8.4) | 86 (2.0) | 2.8 (1.9, 4.0) |
| New osteopenia diagnosis | 170 (7.8) | 152 (3.5) | 1.5 (1.1, 2.1) |
| New osteoporosis diagnosis | 862 (39.5) | 774 (17.7) | 2.3 (1.9, 2.8) |
| Fall | 135 (6.2) | 124 (2.9) | 1.4 (0.9, 2.0) |
| DXA scan | 948 (43.4) | 217 (5.0) | 9.0 (7.6, 10.7) |
| Bone turnover markers | 1 (0.1) | 0 (0.0) | NA |
| At least 1 visit with an osteoporosis specialist (rheumatologist or endocrinologist) | 273 (12.5) | 367 (8.4) | 1.4 (1.0, 1.9) |
| Factors associated with overall health status | |||
| No. of unique days with at least 1 physician visit | 630 (28.8) | 1547 (35.4) | ref |
| 0–1 | |||
| 2–4 | 692 (31.7) | 1386 (31.7) | 0.9 (0.8, 1.1) |
| 5 or more | 863 (39.5) | 1437 (32.9) | 0.9 (0.8, 1.2) |
| Charlson comorbidity index | 1697 (77.7) | 3502 (80.2) | ref |
| 0 | |||
| 1 to 2 | 363 (16.6) | 675 (15.5) | 0.9 (0.7, 1.1) |
| 3+ | 125 (5.7) | 193 (4.4) | 1.0 (0.7, 1.4) |
| At least 1 ER visit | 457 (20.9) | 582 (13.3) | 1.3 (1.0, 1.6) |
| At least 1 day hospitalized as inpatient | 276 (12.6) | 342 (7.9) | 0.8 (0.6, 1.0) |
| Hospitalized stroke, MI, CHD, CVD event | 10 (0.5) | 17 (0.4) | 0.8 (0.3, 2.1) |
| Any skilled nursing facility care | 152 (7.0) | 133 (3.1) | 1.9 (1.3, 2.8) |
| Alzheimer’s or other dementia | 213 (9.8) | 270 (6.2) | 2.0 (1.4, 2.9) |
| Depression or anxiety | 260 (11.9) | 399 (9.1) | 1.0 (0.8, 1.3) |
| Medications | |||
| Alpha blocker | 166 (7.6) | 304 (7.0) | 1.6 (0.9, 2.9) |
| Anticholinergic antihistamine | 24 (1.1) | 39 (0.9) | 1.7 (0.8, 3.7) |
| Antipsychotic | 8 (0.4) | 10 (0.3) | 3.2 (0.4, 27.2) |
| Barbiturate | 2 (0.1) | 2 (0.1) | NA |
| Benzodiazepine | 220 (10.1) | 346 (8.0) | 2.7 (1.8, 3.9) |
| Beta blocker | 790 (36.2) | 1531 (35.0) | 1.1 (0.8, 1.6) |
| Muscle relaxant | 93 (4.3) | 155 (3.6) | 1.1 (0.7, 1.8) |
| Nonbenzodiazepine, benzodiazepine agonist | 79 (3.6) | 184 (4.3) | 0.6 (0.3, 1.1) |
| Opioid | 601 (27.5) | 969 (22.2) | 1.3 (1.1, 1.6) |
| Oral glucocorticoids | 229 (10.5) | 379 (8.7) | 1.2 (0.9, 1.6) |
| Proton pump inhibitor | 537 (24.6) | 993 (22.7) | 1.4 (1.0, 1.9) |
| Selective serotonin reuptake inhibitor | 336 (15.4) | 654 (15.0) | 1.3 (0.8, 1.9) |
| Tricyclic antidepressant | 39 (1.8) | 77 (1.8) | 1.3 (0.5, 3.0) |
| Vasodilator | 97 (4.4) | 198 (4.5) | 0.9 (0.4, 1.7) |
OR = odds ratio; CI = confidence interval; DXA = dual-energy X-ray absorptiometry; ER = emergency room; MI = myocardial infarction; CHD = chronic heart disease; CVD = cardiovascular disease.
Associations significant at p value <0.01 are in bold.
1
Subgroup of the women in Table 3; treatment gap at least 365 days.