References of "Rabenda, Véronique"
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See detailPositive impact of compliance to strontium ranelate on the risk of nonvertebral osteoporotic fractures.
Rabenda, Véronique ULg; Reginster, Jean-Yves ULg

in Osteoporosis International (2010), 21(12), 1993-2002

Adherence is now one of the major issues in the management of osteoporosis. This paper relates the relationship existing between adherence to strontium ranelate and the risk of subsequent nonvertebral ... [more ▼]

Adherence is now one of the major issues in the management of osteoporosis. This paper relates the relationship existing between adherence to strontium ranelate and the risk of subsequent nonvertebral fracture among postmenopausal women with osteoporosis. INTRODUCTION: The aim of this study is to investigate compliance to strontium ranelate (SR) therapy and the impact of compliance on the risk of nonvertebral fractures among women with osteoporosis. METHODS: This study was a post-hoc analysis of pooled data from two international, phase III, randomized, placebo-controlled, double-blind studies (the Spinal Osteoporosis Therapeutic Intervention and Treatment Of Peripheral Osteoporosis). A nested case-control study was performed in the strontium ranelate-treated population. Compliance was quantified using the medication possession ratio (MPR). RESULTS: Two hundred eighty-five nonvertebral fracture cases (hip fx n = 70; major nonvertebral fx n = 213) were identified and matched to 1,425 controls. The mean MPR was 86.8% for controls and 82.6% for cases (p < 0.001). Women who were compliant to SR had a 38% reduction in all nonvertebral fractures compared with those who were not (OR = 0.62; 95%CI[0.47-0.81; p < 0.001). Considering hip fractures only, the risk was reduced by 50% for compliant patients compared to noncompliant patients (OR = 0.50; 95%CI[0.28-0.88]; p < 0.05). CONCLUSION: Our analyses emphasize the importance of good compliance to treatment in order to reduce the risk of osteoporotic fractures. In particular, there was a greater reduction in the risk of nonvertebral and hip fractures with increase compliance. [less ▲]

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See detailOvercoming problems with adherence to osteoporosis medication.
Rabenda, Véronique ULg; Reginster, Jean-Yves ULg

in Expert review of pharmacoeconomics & outcomes research (2010), 10(6), 677-89

Nonadherence to pharmacological treatment in osteoporosis is a well-recognized problem. As in other chronic diseases, adherence to osteoporosis treatment is poor, resulting in enormous burden on patients ... [more ▼]

Nonadherence to pharmacological treatment in osteoporosis is a well-recognized problem. As in other chronic diseases, adherence to osteoporosis treatment is poor, resulting in enormous burden on patients and healthcare resources. Most importantly, low adherence rates consistently result in increased rates of fractures. However, it seems that efforts to evaluate and improve rates of both compliance and persistence are increasing. The extension of dosing intervals may be an element, among others, allowing improvements in therapeutic adherence. Improved patient education, enhancing healthcare provider-patients interaction, taking into account patient's preferences and involving them in treatment decisions may improve adherence. [less ▲]

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See detailPotential Clinical and Economic Impact of Nonadherence with Osteoporosis Medications.
Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg; Gathon, Henry-Jean ULg et al

in Calcified Tissue International (2010), 86

This study aims to estimate the potential clinical and economic implications of therapeutic adherence to bisphosphonate therapy. A validated Markov microsimulation model was used to estimate the impact of ... [more ▼]

This study aims to estimate the potential clinical and economic implications of therapeutic adherence to bisphosphonate therapy. A validated Markov microsimulation model was used to estimate the impact of varying adherence to bisphosphonate therapy on outcomes (the number of fractures and the quality-adjusted life-years [QALYs]), health-care costs, and the cost-effectiveness of therapy compared with no treatment. Adherence was divided into persistence and compliance, and multiple scenarios were considered for both concepts. Analyses were performed for women aged 65 years with a bone mineral density T-score of -2.5. Health outcomes and the cost-effectiveness of therapy improved significantly with increasing compliance and/or persistence. In the case of real-world persistence and with a medical possession ratio (MPR; i.e., the number of doses taken divided by the number of doses prescribed) of 100%, the QALY gain and the number of fractures prevented represented only 48 and 42% of the values estimated assuming full persistence, respectively. These proportions fell to 27 and 23% with an MPR value of 80%. The costs per QALY gained, for branded bisphosphonates (and generic alendronate), were estimated at <euro>19,069 (<euro>4,871), <euro>32,278 (<euro>11,985), and <euro>64,052 (<euro>30,181) for MPR values of 100, 80, and 60%, respectively, assuming real-world persistence. These values were <euro>16,997 (<euro>2,215), <euro>24,401 (<euro>6,179), and <euro>51,750 (<euro>20,569), respectively, assuming full persistence. In conclusion, poor compliance and failure to persist with osteoporosis medications results not only in deteriorating health outcomes, but also in a decreased cost-effectiveness of drug therapy. Adherence therefore remains an important challenge for health-care professionals treating osteoporosis. [less ▲]

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See detailCost-Effectiveness of Osteoporosis Screening Followed by Treatment: The Impact of Medication Adherence.
Hiligsmann, Mickaël ULg; Gathon, Henry-Jean ULg; Bruyère, Olivier ULg et al

in Value in Health (2010), 13(4), 394-401

ABSTRACT Objective: To estimate the impact of medication adherence on the cost-effectiveness of mass-screening by bone densitometry followed by alendronate therapy for women diagnosed with osteoporosis ... [more ▼]

ABSTRACT Objective: To estimate the impact of medication adherence on the cost-effectiveness of mass-screening by bone densitometry followed by alendronate therapy for women diagnosed with osteoporosis. Methods: A validated Markov microsimulation model with a Belgian health-care payer perspective and a lifetime horizon was used to assess the cost per quality-adjusted life year (QALY) gained of the screening/treatment strategy compared with no intervention. Real-world adherence to alendronate therapy and full adherence over 5 years were both investigated. The real-world adherence scenario employed adherence data from published observational studies, and medication adherence was divided into persistence, compliance, and primary adherence. Uncertainty was investigated using one-way and probabilistic sensitivity analyses. Results: At 65 years of age, the costs per QALY gained because of the screening/treatment strategy versus no intervention are euro32,008 and euro16,918 in the real-world adherence and full adherence scenarios, respectively. The equivalent values are euro80,836 and euro40,462 at the age of 55 years, and they decrease to euro10,600 and euro1229 at the age of 75 years. Sensitivity analyses show that the presence of the upfront cost of case finding has a substantial role in the impact of medication adherence on cost-effectiveness. Conclusion: This study indicates that nonadherence with osteoporosis medications substantially increases the incremental cost-effectiveness ratio of osteoporosis screening strategies. All aspects of medication adherence (i.e., compliance, persistence, and primary adherence) should therefore be reported and included in pharmacoeconomic analyses, and especially in the presence of the upfront cost of case finding (such as screening cost). [less ▲]

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See detailThe clinical and economic burden of non-adherence with oral bisphosphonates in osteoporotic patients.
Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg; Bruyère, Olivier ULg et al

in Health Policy (2010), 96

OBJECTIVES: This study aims to estimate the clinical and economic burden of non-adherence with oral bisphosphonates in osteoporotic patients and the potential cost-effectiveness of adherence-enhancing ... [more ▼]

OBJECTIVES: This study aims to estimate the clinical and economic burden of non-adherence with oral bisphosphonates in osteoporotic patients and the potential cost-effectiveness of adherence-enhancing interventions. METHODS: A validated Markov microsimulation model estimated costs and outcomes (i.e. the number of fractures and the quality-adjusted life-year (QALY)) for three adherence scenarios: no treatment, real-world adherence and full adherence over 3 years. The real-world adherence scenario employed data from a published observational study. The incremental cost per QALY gained was estimated and compared across the three adherence scenarios. RESULTS: The number of fractures prevented and the QALY gain obtained at real-world adherence levels represented only 38.2% and 40.7% of those expected with full adherence, respectively. The cost per QALY gained of real-world adherence compared with no treatment was estimated at euro10279, and full adherence was found to be cost-saving compared with real-world adherence. CONCLUSIONS: This study suggests that more than half of the potential clinical benefits from oral bisphosphonates in patients with osteoporosis are lost due to poor adherence with treatment. Depending on their cost, interventions with improved adherence to therapy have the potential to be an attractive use of resources. [less ▲]

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See detailThe clinical and economic burden of non-adherence with oral bisphosphonates in osteoporotic patients
Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg; Bruyère, Olivier ULg et al

in Arthritis and Rheumatism (2009, October), 60(number 10 (suppl.)), 328

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See detailThe clinical and economic burden of nonadherence with osteoporosis medications
Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg; Bruyère, Olivier ULg et al

in Value in Health (2009, October), 12(7), 444

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See detailThe clinical and economic burden of nonadherence with oral bisphosphonates in osteoporotic patients
Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg; Reginster, Jean-Yves ULg

in Annals of the Rheumatic Diseases (2009, June), 68(S3), 667

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See detailClinical en economic implications of non-adherence with osteoporosis medications
Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg; Gathon, Henry-Jean ULg et al

in Osteoporosis International (2009, March), 20(S1), 16

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See detailPositive impact of compliance to strontium ranelate on the risk of non-vertebral osteoporotic fractures
Rabenda, Véronique ULg; Reginster, Jean-Yves ULg

in Osteoporosis International (2009, March), 20(Suppl.1), 89

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See detailRelationship between changes in bone mineral density and compliance to strontium ranelate
Rabenda, Véronique ULg; Bruyère, Olivier ULg; Reginster, Jean-Yves ULg

in Osteoporosis International (2009, March), 20(Suppl.1), 152-153

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See detailIbandronate in the management of postmenopausal osteoporosis
Reginster, Jean-Yves ULg; Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg et al

in Clinical Medicine. Therapeutics (2009), 1

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See detailPoor adherence to oral bisphosphonate treatment and its consequences: a review of the evidence.
Rabenda, Véronique ULg; Hiligsmann, Mickaël ULg; Reginster, Jean-Yves ULg

in Expert Opinion on Pharmacotherapy (2009), 10(14), 2303-15

Poor therapeutic adherence is a major issue faced by physicians today. This paper summarizes the adherence rates with oral bisphosphonate (OBP) treatment in clinical practice and their impact on clinical ... [more ▼]

Poor therapeutic adherence is a major issue faced by physicians today. This paper summarizes the adherence rates with oral bisphosphonate (OBP) treatment in clinical practice and their impact on clinical outcomes. Studies systematically demonstrated that overall compliance and persistence with OBPs among osteoporotic women are poor. Although extending dosing intervals improved adherence, the gains are suboptimal. Most importantly, low compliance and persistence rates consistently resulted in increased rates of fractures. The results emphasize the importance of adherence to treatment to achieve optimal antifracture efficacy. There is an urgent need to implement strategies and to encourage physicians to take measures that increase patients' awareness of the need to use osteoporosis medications as directed in order to benefit from them fully. [less ▲]

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See detailLoss of hip bone mineral density over time is associated with spine and hip fracture incidence in osteoporotic postmenopausal women.
Bruyère, Olivier ULg; Varela, A. R.; Adami, S. et al

in European journal of epidemiology (2009), 24

The objective of the study assess the relationship between bone mineral density (BMD) loss over time and fracture incidence in postmenopausal women. This is a posthoc analysis that includes women from the ... [more ▼]

The objective of the study assess the relationship between bone mineral density (BMD) loss over time and fracture incidence in postmenopausal women. This is a posthoc analysis that includes women from the placebo group of two large randomized controlled trials having assessed the efficacy of a new anti-osteoporotic drug. BMD was assessed every 6 months during 3 years at the lumbar spine, the femoral neck and the total proximal femur. Vertebral fractures were assessed using a semiquantitative method. Hip fractures were based on written documentation. All patients received calcium and vitamin D. In the present study that included 1,775 patients (with complete data at baseline and after 3 years), the logistic regression analysis, adjusted for covariates, showed that 3-year change in lumbar BMD was not statistically associated with the new vertebral fractures after 3 years. However, femoral neck and total proximal femur BMD changes was statistically correlated with the incidence of new vertebral fractures (P < 0.001). When considering change in BMD after the first year of follow-up, a decrease in total proximal femur BMD was statistically associated with an increase in the incidence of new vertebral fractures during the last 2 years of follow-up (P = 0.048). The 3-year change in femoral neck and total proximal BMD was statistically correlated with the incidence of hip and fragility fracture after 3 years (all P < 0.001). In this elderly osteoporotic population receiving calcium and vitamin D, a decrease in hip BMD after 1 or 3 year of follow-up, is associated with an increased risk of fracture incidence. However, spine BMD changes do not influence vertebral fracture incidence. [less ▲]

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See detailImpact of medication non-compliance and non-persistence on pharmacoeconomic evaluations in osteoporosis
Hiligsmann, Mickaël ULg; Rabenda, Véronique ULg; Gathon, Henry-Jean ULg et al

in Osteoporosis International (2008, December), 19(S2), 282

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