DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20193191

Evaluation of prescription pattern and quality of life in postmenopausal osteoporosis: a cross sectional study

Siddharth Pravin Agrawal, Suhani V. Patel, Supriya Malhotra, Pankaj R. Patel

Abstract


Background: Osteoporosis (OP) is a silently progressing metabolic bone disease that results in loss of mineralized bone and subsequent fractures with minor trauma. Fracture related pain and physical inability to perform activities of daily living can lead to psychological consequences that impair Quality of Life (QoF). However, much less is known about Indian scenario. Hence, our study becomes imperative. Aim of this study to the drug utilization pattern and to analyze Quality of life of postmenopausal women suffering from osteoporosis.

Methods: An analytical cross-sectional study was done on 91 post-menopausal osteoporotic women. Drug utilization pattern was evaluated. Pre-validated QUALEFFO-31 questionnaire was administered to each patient to record patient’s perceived QoL. Scores were calculated according to the algorithm. Higher scores indicated poor QoL. The collected data was analyzed with SPSS software (version 23)and p value ≤0.05 was considered as statistically significant.

Results: The mean age group of presenting patients was 56.2±6.6 years. All the patients received Calcium and vitamin D supplements and non-steroidal anti-inflammatory drugs for pain relief. But only 33% of the patients received any one of the bisphosphonates (BP). For analysis, patients were grouped into Group-1(n=60) who did not and Group-2 (n=31) who did receive a BP. QOL analysis showed that pain domain was affected the most. Also, patients in Group 2 reported worse score in all the domains in comparison to Group 1 (P<0.05). It is likely that BP might need more time to show considerable effect or because it was added only to those patients who already had more complaints and could afford the high cost.

Conclusion: BP in spite of being the drug of choice for OP is used less commonly in India. OP causes pain and physical debilitation with detrimental effect on mental health. Longer duration prospective studies are needed to study the association of QoL and use of BP in OP patients.


Keywords


Drug utilization study, Epidemiology, Osteoporosis

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References


Teng GG, Curtis ER, Saag KG. Mortality and osteoporotic fractures: is the link causal, and is it modifiable? Clin Exp Rheumatol. 2008:26(50):125-37.

Kanis JA, World Health Organization Scientific Group. WHO technical report. University of Sheffield, UK. 2007;66.

Malhotra, A and Mithal, A. Osteoporosis in Indians. Indian J Med Res. 2008:127;263-8.

Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, et al. Bone health in healthy Indian population aged 50 years and above. Osteoporos Int. 2011;22:2829-36

Emkey R. Alendronate and risedronate for the treatment of ostmenopausal osteoporosis: clinical profiles of the once-weekly and once-daily dosing formulations. Med Gen Med. 2004Jul19;6(3):6.

Han SL, Wan SL. Effect of teriparatide on bone mineral density and fracture in postmenopausal osteoporosis: meta‐analysis of randomised controlled trials. Int J clin practice. 2012 Feb;66(2):199-209.

Lips P, van Schoor NM. Quality of life in patients with osteoporosis.Osteoporos Int. 2005;16(5):447-55.

Wilson S, Sharp CA, Davie MW. Health-related quality of life in patients with osteoporosis in the absence of vertebral fracture: a systematic review. Osteoporos Int. 2012Dec;23(12):2749-68.

Van Schoor NM, Knol DL, Glas CA, Ostelo RW, Leplège A, Cooper C, et al. Development of the Qualeffo-31, an osteoporosis-specific quality-of-life questionnaire. Osteoporos Int. 2006;17(4):543-51.

Tripathy A, Adiga S, Shah HH, Shanbhag TV, Mahesh Kumar D. A retrospective study of clinical profile and drug prescribing pattern in osteoporosis in a tertiary care hospital. Int J Pharmacy and Pharmaceutical Sciences. 2015Jan1;7(10):3903.

Cortet B, Blotman F, Debiais F, Huas D, Mercier F, Rousseaux C, et al. Management of osteoporosis and associated quality of life in post-menopausal women. BMC Musculoskelet Disord. 2011Jan12;12:7.

Schneider JP. Should bisphosphonates be continued indefinitely? An unusual fracture in a healthy woman on long-term alendronate. Geriatrics. 2006;61:(1):31-3.

Tandon VR, Sharma S, Mahajan S, Mahajan A, Khajuria V, Gillani Z. First Indian prospective randomized comparative study evaluating adherence and compliance of postmenopausal osteoporotic patients for daily alendronate, weekly risedronate and monthly ibandronate regimens of bisphosphonates. J Midlife Health. 2014Jan;5(1):29-33.

Aggarwal N, Raveendran A, Khandelwal N, Sen RK, Thakur JS, Dhaliwal LK, et al. Prevalence and related risk factors of osteoporosis in peri- and postmenopausal Indian women. Journal of Mid-Life Health. 2011;2(2):81-5.

Shivakumar V, Sudhir G, Priyadarshini SP, Shanmugam M, Relationship Between Osteoporosis and Periodontitis. Chettinad Health City Medical J. 2012;1(1):19-27.

Wong CC, McGirt MJ. Vertebral compression fractures: a review of current management and multimodal therapy. J Multidisciplinary Healthcare. 2013;6:205-14.

Bączyk G, Opala T, Kleka P. Quality of life in postmenopausal women with reduced bone mineral density: psychometric evaluation of the Polish version of QUALEFFO-41. Archives of Medical Science : AMS. 2011;7(3):476-85.

Xenodemetropoulos T, Davison S, Ioannidis G, Adachi JD. The impact of fragility fracture on health-related quality of life : the importance of antifracture therapy. Drugs Aging. 2004;21(11):711-30.

Bianchi ML, Orsini MR, Saraifoger S, Ortolani S, Radaelli G, Betti S. Quality of life in post-menopausal osteoporosis. Health and Quality of Life Outcomes. 2005;3:78.