Irrational use of alendronate sodium by the elderly
DOI:
https://doi.org/10.5712/rbmfc15(42)2310Keywords:
Alendronate, Elderly, Osteoporosis, PharmacoepidemiologyAbstract
Introduction: The effectiveness and safety of alendronate sodium are dependent on patient adherence to very specific guidelines regarding use. This study aims to estimate the rational use of alendronate sodium in the elderly. Methods: This is a cross-sectional study carried out with a structured questionnaire containing form of use and occurrence of adverse events related to alendronate sodium. The patients were recruited in their own homes. Rational use was considered as being the participants who: a) took the tablet in the morning; b) were fasting; c) waited at least 30 minutes before eating; d) ingested with a full glass of water; e) ingested the whole tablet; f) and remained in the orthostatic position for at least 30 minutes after use. Additionally, the odds ratio (OR) was used to analyze the association between the irrational use of alendronate sodium and the independent variables. Results and Discussion: Of the 248 participants in the study, most of the participants administered the medication in the morning (95.2%), with fasting (89.1%), waited at least 30 minutes to eat the first meal of the day (87.9%), and were in the orthostatic position until the time of the first meal (78.6%), but less than half ingested the tablet with a full glass of water (43.6%). Rational use of the medication was observed in only 30.7% of the participants. Regarding possible adverse events, 13.3% of the participants reported some event. Among the most prevalent were dry cough (6.5%), stomach pain (5.2%) and some throat discomfort (4.8%). The irrational use of this medication is associated with age and education level. Conclusion: The prevalence of irrational use of alendronate sodium in the elderly is high, and this use is associated with patients’ sociodemographic factors.
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(1) Ministério da Saúde (BR). Portaria nº 3.916, de 30 de outubro de 1998. Dispõe sobre a aprovação da Política Nacional de Medicamentos. Diário Oficial da União, Brasília (DF), 31 out 1998; [access in 2018 Jan 21]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/1998/prt3916_30_10_1998.html
(2) World Health Organization (WHO). The pursuit of responsible use of medicines: sharing and learning from country experiences. Geneva: WHO; 2012; [access in 2018 Mar 28]. Available from: http://www.who.int/medicines/areas/rational_use/en/
(3) World Health Organization (WHO). Promoción del uso racional de medicamentos : componentes centrales. Geneva: WHO; 2002. p. 1-6.
(4) Agência Nacional de Vigilância Sanitária (ANVISA). Parcerias para diminuir o mau uso de medicamentos. Rev Saúde Pública. 2006;40(1):191-3. DOI: https://doi.org/10.1590/S0034-89102006000100029 DOI: https://doi.org/10.1590/S0034-89102006000100029
(5) Ministério da Saúde (BR). Portaria No. 96/2018, de 18 de maio de 2018. Regulamenta a organização e funcionamento do Registo Nacional do Testamento Vital (RENTEV) [Internet]. Diário da República, Lisboa (PT), 2018 mai 18; 2211-2; [access in 2019 Jun 10]. Available from: https://data.dre.pt/eli/port/141/2018/05/18/p/dre/pt/htm
(6) Camacho PM, Petak SM, Binkley N, Clarke BL, Harris ST, Hurley DL, et al. American Association of Clinical Endocrinologists and American College of Endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis - 2016 - executive summary. Endocr Pract. 2016 Sep;22(9):1111-8. DOI: https://doi.org/10.4158/EP161435.ESGL DOI: https://doi.org/10.4158/EP161435.ESGL
(7) Meng J, Hu L. Positively-charged microemulsion for improving the oral bioavailability of alendronate: in-vitro and in-vivo assessment. J Pharm Pharmacol. 2011;63(3):400-8. PMID: 21749388 DOI: https://doi.org/10.1111/j.2042-7158.2010.01229.x DOI: https://doi.org/10.1111/j.2042-7158.2010.01229.x
(8) Reid IR. Efficacy, effectiveness and side effects of medications used to prevent fractures. J Intern Med. 2015 Jun;277(6):690-706. DOI: https://doi.org/10.1111/joim.12339 DOI: https://doi.org/10.1111/joim.12339
(9) Yazbek MA, Marques Neto JF. Doenças osteometabólicas. Osteoporose e outras doenças osteometabólicas no idoso. Eistein (São Paulo). 2008;6(Supl 1):S74-S8.
(10) Fardellone P, Lello S, Cano A, Moreira ES, Oliveira RW, Julian GS, et al. Real-world adherence and persistence with bisphosphonate therapy in postmenopausal women: a systematic review. Clin Ther [Internet]. 2019 Aug;41(8):1576-88. DOI: https://doi.org/10.1016/j.clinthera.2019.05.001 DOI: https://doi.org/10.1016/j.clinthera.2019.05.001
(11) Sözen T, Özisik L, Basaran NC. An overview and management of osteoporosis. Eur J Rheumatol. 2017 Mar;4(1):46-56. PMID: 28293453 DOI: https://doi.org/10.5152/eurjrheum.2016.048 DOI: https://doi.org/10.5152/eurjrheum.2016.048
(12) Baccaro LF, Conde DM, Costa-Paiva L, Pinto-Neto AM. The epidemiology and management of postmenopausal osteoporosis: a viewpoint from Brazil. Clin Interv Aging [Internet]. 2015 Mar; [cited 2018 Mar 28]; 10:583-91. Available from: http://www.dovepress.com/the-epidemiology-and-management-of-postmenopausal-osteoporosis-a-viewp-peer-reviewed-article-CIA%5Cn PMID: 25848234 DOI: https://doi.org/10.2147/CIA.S54614 DOI: https://doi.org/10.2147/CIA.S54614
(13) Moraes LFS, Silva EN, Silva DAS, Paula AP. Gastos com o tratamento da osteoporose em idosos do Brasil (2008-2010): análise dos fatores associados. Rev Bras Epidemiol. 2014;17(3):719-34. DOI: https://doi.org/10.1590/1809-4503201400030012
(14) Horne R. Treatment perceptions and self-regulation. In: Cameron LD, Leventhal H, eds. The self-regulation of health and illness behaviour. London, UK: Routledge; 2003. p. 138-53.
(15) Hansen C, Pedersen BD, Konradsen H, Abrahamsen B. Anti-osteoporotic therapy in Denmark--predictors and demographics of poor refill compliance and poor persistence. Osteoporos Int. 2013;24(7):2079-97. DOI: https://doi.org/10.1007/s00198-012-2221-5 PMID: 23179576
(16) Instituto Brasileiro de Geografia e Estatística (IBGE). Panorama das cidades [Internet]. Brasília (DF): IBGE; 2019; [access in 2019 Jun 10]. Available from: https://www.ibge.gov.br/cidades-e-estados/mg/divinopolis.html
(17) Micromedex Solutions. Drug interactions [Internet]. Ann Arbor, MI: Truven Health Analytics Inc.; 2013; [access in 2017 Jan 31]. Available from: https://www.micromedexsolutions.com/micromedex2/4.14.0/WebHelp/Tools/Interactions/Drug_Interactions.htm
(18) Silva RAS. Questionário estruturado alendronato de sódio and orientações para uso de alendronato de sódio [Internet]. Charlottesville, VA: Open Science Framework (OSF); 2020. Available from: https://osf.io/8a6fb
(19) Nobre C, Vieira VMSF, Nobre CA, Pamplona YAP. Caracterização do uso do alendronato para osteoporose na Atenção Primária à Saúde. Rev Bras Med Fam Comunidade. 2016 Apr;11(38):1-9. DOI: http://doi.org/10.5712/rbmfc11(38)901 DOI: https://doi.org/10.5712/rbmfc11(38)901
(20) Dewulf NLS, Santos V, Pereira LRL, Troncon LEA. The invisible pharmacist. Am J Hosp Pharm Educ. 2009 Jul;73(4):74. DOI: https://doi.org/10.5688/aj730474
(21) Machin R, Couto MT, Silva GSN, Schraiber LB, Figueiredo WS, Valença OA, et al. Concepção de gênero, masculinidade e cuidados em saúde: estudo com profissionais de saúde da atenção primária. Ciênc Saúde Coletiva. 2011 Nov;16(11):4503-12. DOI: https://doi.org/10.1590/s1413-81232011001200023 DOI: https://doi.org/10.1590/S1413-81232011001200023
(22) Costa-Júnior FM, Maia ACB. Concepção de homens hospitalizados sobre a relação entre gênero e saúde. Psicol Teor e Pesqui. 2009 Mar;25(1):55-63. DOI: https://doi.org/10.1590/S0102-37722009000100007 DOI: DOI: https://doi.org/10.1590/S0102-37722009000100007
(23) Aquino EML, Araujo MJ, Almeida MCC, Conceição P, Andrade CR, Cade NV, et al. Recrutamento de participantes no Estudo Longitudinal de Saúde do Adulto. Rev Saúde Pública [Internet]. 2013 Jun; [cited 2018 Mar 29]; 47(Suppl 2):10-8. Avaliable from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102013000800010&lng=en DOI: https://doi.org/10.1590/S0034-8910.2013047003953 DOI: https://doi.org/10.1590/S0034-8910.2013047003953
(24) Leite MOR. Tratamento da osteoporose pós-menopausa. Arq Bras Endocrinol Metab. 1999;43(6):442-5. DOI: https://doi.org/10.1590/S0004-27301999000600009 DOI: https://doi.org/10.1590/S0004-27301999000600009
(25) Ribeiro AF, Volpato NM. Alendronato de sódio: metodologias para análise quantitativa. Quím Nov. 2005 Oct;28(5):852-8. DOI: https://doi.org/10.1590/S0100-40422005000500024 DOI: https://doi.org/10.1590/S0100-40422005000500024
(26) Diab DL, Watts NB. Biophosphonate drug holiday: who, when and how long. Ther Adv Musculoskelet Dis. 2013 May;5(3):107-11. DOI: https://doi.org/10.1177/1759720X13477714 DOI: https://doi.org/10.1177/1759720X13477714
(27) Caires ELP, Bezerra MC, Junqueira AFTA, Fontenele SMA, Andrade SCA, D’Alva CB. Tratamento da osteoporose pós-menopáusica: um algoritimo baseado na literatura para uso no sistema público de saúde. Rev Bras Reumatol. 2017 May/Jun;57(3):254-63. DOI: https://doi.org/10.1016/j.rbre.2017.01.001 DOI: https://doi.org/10.1016/j.rbre.2017.01.001
(28) Flores LM, Mengue SS. Drug use by the elderly in Southern Brazil. Rev Saúde Pública. 2005;39(6):924-9. PMID: 16341402 DOI: https://doi.org/10.1590/S0034-89102005000600009
(29) Baldoni AO, Dewulf NLS, Santos V, Reis TM, Ayres LR, Pereira LRL. Dificuldades de acesso aos serviços farmacêuticos pelos idosos. Rev Ciênc Farm Básica Apl. 2014;35(4):615-21.
(30) Guénette L, Moisan J. Elderly people’s knowledge of the porpose of their medicines. Am J Geriatr Pharmacother. 2011 Feb;9(1):49-57. DOI: https://doi.org/10.1016/j.amjopharm.2011.02.007 DOI: https://doi.org/10.1016/j.amjopharm.2011.02.007
(31) Reis TM, Guidoni CM, Girotto E, Rascado RR, Mastroianni PC, Cruciol JM, et al. Pharmaceutical care in Brazilian community pharmacies: knowledge and practice. Afr J Pharm Pharmacol. 2015;9(9):287-94. DOI: https://doi.org/10.5897/AJPP2014.4239 DOI: https://doi.org/10.5897/AJPP2014.4239
(32) Melo AC, Galato D, Maniero HK, Frade JCQP, Palhano TJ, Silva WB, et al. Pharmacy in Brazil: progress and challenges on the road to expanding clinical practice. Can J Hosp Pharm. 2017;70(5):381-90. DOI: https://doi.org/10.4212/cjhp.v70i5.1700 PMID: 29109582 DOI: https://doi.org/10.4212/cjhp.v70i5.1700
(33) Landfeldt E, Ström O, Robbins S, Borgström F. Adherence to treatment of primary osteoporosis and its association to fractures--the Swedish Adherence Register Analysis (SARA). Osteoporos Int. 2012;23(2):433-43. DOI: https://doi.org/10.1007/s00198-011-1549-6 PMID: 21286686 DOI: https://doi.org/10.1007/s00198-011-1549-6
(34) Devold HM, Furu K, Skurtveit S, Tverdal A, Falch JA, Sogaard AJ. Influence of socioeconomic factors on the adherence of alendronate treatment in incident users in Norway. Pharmacoepidemiol Drug Saf. 2012 Jan;21(3):297-304. DOI: https://doi.org/10.1002/pds.2344 DOI: https://doi.org/10.1002/pds.2344
(35) Hansen C, Pedersen BD, Konradsen H, Abrahamsen B. Anti-osteoporotic therapy in Denmark-predictors and demographics of poor refill compliance and poor persistence. Osteoporos Int. 2013;24(7):2079-97. DOI: https://doi.org/10.1007/s00198-012-2221-5 PMID: 23179576 DOI: https://doi.org/10.1007/s00198-012-2221-5
(36) Laliberté MC, Perreault S, Damestoy N, Lalonde L. The role of community pharmacists in the prevention and management of osteoporosis and the risk of falls: results of a cross-sectional study and qualitative interviews. Osteoporos Int. 2013;24(6):1803-15. DOI: https://doi.org/10.1007/s00198-012-2171-y PMID: 23070479 DOI: https://doi.org/10.1007/s00198-012-2171-y
(37) Recker RR, Lewiecki EM, Miller PD, Reiffel J. Safety of bisphosphonates in the treatment of osteoporosis. Am J Med [Internet]. 2009 Feb;122(2 Suppl):S22-S32. DOI: http://doi.org/10.1016/j.amjmed.2008.12.004 PMID: 19187809 DOI: https://doi.org/10.1016/j.amjmed.2008.12.004
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