References of "Rabenda, Véronique"
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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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See detailLow incidence of anti-osteoporosis treatment after hip fracture.
Rabenda, Véronique ULg; Vanoverloop, Johan; Fabri, Valerie et al

in Journal of Bone & Joint Surgery. American Volume (2008), 90(10), 2142-8

BACKGROUND: Following hip fracture, pharmacologic treatment can reduce the rate of subsequent fragility fractures. The objective of the present study was to assess the proportion of patients who are ... [more ▼]

BACKGROUND: Following hip fracture, pharmacologic treatment can reduce the rate of subsequent fragility fractures. The objective of the present study was to assess the proportion of patients who are managed with bisphosphonates or selective estrogen-receptor modulators after hip fracture and to evaluate, among those managed with alendronate, the twelve-month compliance and persistence with treatment. METHODS: Data were gathered from health insurance companies and were collected by AIM (Agence Intermutualiste) for the Belgian National Social Security Institute (INAMI). We selected all postmenopausal women who had been hospitalized for a hip fracture between April 2001 and June 2004 and had not been previously managed with bisphosphonates. Patients who had received alendronate treatment after the hip fracture were categorized according to their formulation use during the follow-up study (daily, weekly, daily followed by weekly, or weekly followed by weekly). Compliance at twelve months was quantified with use of the medication possession ratio (i.e., the number of days of alendronate supplied during the first year of treatment, divided by 365). Persistence with prescribed treatment was calculated as the number of days from the initial prescription to a lapse of more than five weeks after completion of the previous prescription refill. The cumulative treatment persistence rate was determined with use of Kaplan-Meier survival curves. RESULTS: A total of 23,146 patients who had sustained a hip fracture were identified. Of these patients, 6% received treatment during the study period: 4.6% received alendronate, 0.7% received risedronate, and 0.7% received raloxifene. Bisphosphonate treatment was dispensed to 2.6% and 3.6% of the patients within six months and one year after the occurrence of the hip fracture, respectively. Among women who received alendronate daily (n = 124) or weekly (n = 182) and were followed for at least one year after the hip fracture, the twelve-month mean medication possession ratio was 67% (65.9% in the daily group and 67.7% in the weekly group). The analysis of persistence with treatment included a total of 726 patients (142 in the daily group, 261 in the weekly group, and 323 in the switch group). At twelve months, the rate of persistence was 41% and the median duration of persistence was 40.3 weeks. CONCLUSIONS: The vast majority of patients who experience a hip fracture do not take anti-osteoporotic therapy after the fracture. Furthermore, among patients who begin alendronate treatment after the fracture, the adherence to treatment decreases over time and remains suboptimal. [less ▲]

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