Physicians’ perspectives on the treatment of osteoporosis patients with bisphosphonates

Figures & data

Table 1 Demographic and clinical characteristics of participating physicians

Characteristic	Na	%
Sex
Male	122	77.7
Female	35	22.3
Age group (years)
<30	0	0.0
30–44	21	13.4
45–60	106	67.5
>60	30	19.1
Geographic region
Northeast	54	34.2
Midwest	50	31.6
South	11	7.0
West	40	25.3
Other	3	1.9
Years in practice
<5	1	0.6
5 to <10	4	2.6
10 to <15	19	12.1
15 to <20	41	26.1
≥20	92	58.6
Current practice setting
Solo practice	59	37.6
Group practice	96	61.1
Some other arrangement	2	1.3
Associated with an academic teaching center
Yes	55	35.0
No	102	65.0
Primary specialty
Primary care	123	78.3
Internal medicine	69	43.9
General or family practice	54	34.4
Specialist	32	20.4
Rheumatology	22	14.0
Endocrinology	10	6.4
Some other specialty	2	1.3

Note:

a One physician failed to provide demographic data, except for geographic region.

Figure 1 Considerations in physicians’ decisions to treat female osteoporosis patients with oral bisphosphonates.

Note: Missing answers are not presented in the figure, so some bars do not sum to 100%.

Table 2 Physicians’ preferences for osteoporosis medication in female osteoporosis patients

	Newly diagnosed patients (N, %)		Long-term users of oral BPs (N, %)
Daily oral BP drug therapy	1	0.6	2	1.3
Weekly oral BP drug therapy	86	54.4	64	40.5
Monthly oral BP drug therapy	54	34.2	57	36.1
Infusion/IV drug therapy	7	4.4	12	7.6
Injectable drug therapy	10	6.3	23	14.6

Abbreviations: BP, bisphosphonate; IV, intravenous.

Table 3 Length of oral bisphosphonate therapy and drug holidays

Survey question	N	%
Length of oral BP therapy physicians felt was required for the medication to be effective in reducing the risk of fracture
Less than 3 months	3	1.9
3 to <6 months	5	3.2
6 to <12 months	38	24.1
12 to <15 months	33	20.9
15 to <18 months	6	3.8
18 to <24 months	24	15.2
24 to <36 months	28	17.7
≥36 months	21	13.3
Recommendation of a drug holiday/stopping the use of BP therapy, for patients with osteoporosis who are on oral BP therapy
Yes, always	37	23.4
Yes, sometimes	93	58.9
No	28	17.7
Length of time before recommending a drug holiday for osteoporosis patients on oral BP therapya
After <1 year of persistence and compliance	0	0.0
After 1 year of persistence and compliance	7	5.4
After 2 years of persistence and compliance	19	14.6
After 3 years of persistence and compliance	13	10.0
After 4 years of persistence and compliance	9	6.9
After 5 years of persistence and compliance	68	52.3
After >6 years of persistence and compliance	8	6.2
No specific time; it depends on the patient	6	4.6
Main reason for recommending a drug holiday for osteoporosis patients on oral BP therapya
Drug holidays are beneficial to patient treatment patterns	23	17.7
Patient expresses concerns about medication side effects	26	20.0
Patient expresses other concern about taking medication	15	11.5
Research indicates that drug holidays are necessary	39	30.0
Patient does not show sign of benefit from medication	8	6.2
Patient shows sign of benefit from medication	8	6.2
Other reason	11	8.5

Note:

a Among 130 providers answering “yes” to Q11.

Abbreviation: BP, bisphosphonate.

Figure 2 Physicians’ ratings of patients’ acceptability of oral bisphosphonate drug therapy.

Figure 3 Physicians’ estimates of patients’ persistence and compliance with oral bisphosphonates.

Notes: Persistence was defined as taking the medication for the specified period, with no gaps in therapy of 2 months or longer. Compliance was defined as taking the medication for the specified period and following dosing instructions at least 70% of the time.

Figure 4 Physician-reported reasons for patients’ noncompliance with oral bisphosphonates.