Which Bisphosphonate? It's the Compliance!: Decision Analysis.
10.11005/jbm.2016.23.2.79
- Author:
You Jin LEE
1
;
Chan Ho PARK
;
Young Kyun LEE
;
Yong Chan HA
;
Kyung Hoi KOO
Author Information
1. Department of Internal Medicine, Center for Thyroid Cancer, National Cancer Center, Goyang, Korea.
- Publication Type:Original Article
- Keywords:
Diphosphonates;
Fractures bone;
Osteoporosis postmenopausal;
Patient compliance
- MeSH:
Compliance*;
Consensus;
Decision Support Techniques*;
Decision Trees;
Diphosphonates;
Female;
Hip;
Humans;
Osteoporotic Fractures;
Patient Compliance;
Quality of Life;
Uncertainty
- From:Journal of Bone Metabolism
2016;23(2):79-83
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The best options of several bisphosphonates for prevention of osteoporotic fractures in postmenopausal women remain controversial. We determined which bisphosphonate provides better efficacy in prevention of osteoporotic fractures using a decision analysis tool, in terms of quality of life. METHODS: A decision analysis model was constructed containing final outcome score and the probability of vertebral and hip fracture within 1 year. Final outcome was defined as health-related quality of life, and was used as an utility in the decision tree. Probabilities were obtained by literature review, and health-related quality of life was evaluated by consensus committee. A roll back tool was used to determine the best bisphosphonate, and sensitivity analysis was performed to compensate for decision model uncertainty. RESULTS: The decision model favored bisphosphonate with higher compliance in terms of quality of life. In one-way sensitivity analysis, ibandronate was more beneficial than the others, when probability of compliance on ibandronate was above 0.589. CONCLUSIONS: In terms of quality of life, the decision analysis model showed that compliance was most important for patients in real world, regardless of type of bisphosphonate.