Dr. Wittink is deceased.
Patient treatment preferences for osteoporosis
Article first published online: 29 SEP 2006
Copyright © 2006 by the American College of Rheumatology
Arthritis Care & Research
Volume 55, Issue 5, pages 729–735, 15 October 2006
How to Cite
Fraenkel, L., Gulanski, B. and Wittink, D. (2006), Patient treatment preferences for osteoporosis. Arthritis & Rheumatism, 55: 729–735. doi: 10.1002/art.22229
- Issue published online: 29 SEP 2006
- Article first published online: 29 SEP 2006
- Manuscript Accepted: 11 JAN 2006
- Manuscript Received: 28 OCT 2005
- Arthritis Foundation Clinical Science grant
- NIH/National Center for Research Resources. Grant Number: M01-RR-00125
- National Institute of Arthritis and Musculoskelatal and Skin Diseases K23 award. Grant Number: AR048826-01 A1
- Recombinant human parathyroid hormone;
- Decision making
To examine patient preferences for currently available and promising osteoporosis treatment options.
We recruited patients who had recently (within 2 weeks) undergone bone densitometry and were found to have osteoporosis. Consenting participants completed an Adaptive Conjoint Analysis questionnaire to determine their treatment preferences for oral bisphosphonates taken once per week, intravenous bisphosphonates administered every 3 months, intravenous bisphosphonates administered once per year, and subcutaneous recombinant human parathyroid hormone (rhPTH). We performed simulations based on respondents' values for route of administration, absolute reduction in risk of vertebral and hip fractures over 5 years, and risk of adverse effects to predict each respondent's treatment choice.
The study sample included 201 women and 11 men (median age 73). Patients' treatment preferences were strongly influenced by route of administration. Patients' preferred treatment option, across all simulations, was bisphosphonates. Among 80 treatment-naive participants, 52 (65%) preferred an annual infusion over oral weekly bisphosphonates. Participants with poorer perceived health status, those with a high perceived risk of future fracture, and participants preferring to treat health problems without doctors or prescription drugs were more likely to prefer an annual infusion over weekly pills.
Patient preferences for osteoporosis treatment options are strongly influenced by route of administration. Therefore, despite the added benefits of rhPTH, patients' preferred treatment option for osteoporosis is bisphosphonates. Among those preferring bisphosphonates, many preferred annual infusions over weekly oral medications, emphasizing the need to incorporate individual patient preferences into treatment decisions for osteoporosis. The latter is especially important given the poor rates of long-term adherence to osteoporosis medications.