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 ULiege; Reginster, Jean-Yves ULiege

in Osteoporosis International (2008), 19(S2), 366-367

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See detailLow incidence of anti-osteoporosis treatment after hip fracture.
Rabenda, Véronique ULiege; 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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See detailAdherence to bisphosphonates therapy and hip fracture risk in osteoporotic women.
Rabenda, Véronique ULiege; Mertens, R.; Fabri, V. et al

in Osteoporosis International (2008), 19(6), 811-8

Adherence is now one of the major issues in the management of osteoporosis and several papers have suggested that vertebral fractures might be increased in patients who do not follow appropriately their ... [more ▼]

Adherence is now one of the major issues in the management of osteoporosis and several papers have suggested that vertebral fractures might be increased in patients who do not follow appropriately their prescriptions. This paper relates the strong relationship existing between adherence to anti-osteoporosis treatment and the risk of subsequent hip fracture. INTRODUCTION: A study was performed to investigate adherence to bisphosphonate (BP) therapy and the impact of adherence on the risk of hip fracture (Fx). METHODS: An exhaustive search of the Belgian national social security database was conducted. Patients enrolled in the study were postmenopausal women, naive to BP, who received a first prescription of alendronate. Compliance at 12 months was quantified using the medication possession ratio (MPR). Persistence was calculated as the number of days from the initial prescription to a gap of more than 5 weeks after completion of the previous refill. A logistic regression model was used to estimate the impact of compliance on the risk of hip fracture. The impact of persistence on hip fracture risk was analysed using the Cox proportional hazards model. RESULTS: The mean MPR at 12 months was significantly higher among patients receiving weekly (n = 15.021) compared to daily alendronate (n = 14,136) (daily = 58.6%; weekly = 70.5%; p < 0.001). At 12 months, the rate of persistence was 39.45%. For each decrease of the MPR by 1%, the risk of hip Fx increased by 0.4% (OR: 0.996; CI 95%: 0.994-0.998; p < 0.001). The relative risk reduction for hip Fx was 60% (HR: 0.404; CI 95%: 0.357-0.457; p < 0.0001) for persistent compared to non-persistent patients. CONCLUSION: These results confirm that adherence to current therapeutic regimens remains suboptimal. [less ▲]

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See detailAdherence to treatment of osteoporosis: a need for study
Lekkerkerker, F.; Kanis, J. A.; Alsayed, N. et al

in Osteoporosis International (2007), 18(10), 1311-1317

Adherence to anti-osteoporosis medications is currently low and is associated with poor anti-fracture efficacy. This manuscript reviews the potential design of clinical studies that aim to demonstrate ... [more ▼]

Adherence to anti-osteoporosis medications is currently low and is associated with poor anti-fracture efficacy. This manuscript reviews the potential design of clinical studies that aim to demonstrate improved adherence, with new chemical entities to be used in the management of osteoporosis. Introduction Several medications have been unequivocally shown to decrease fracture rates in clinical trials. However, in real life settings, long-term persistence and compliance to anti-osteoporosis medication is poor, hence decreasing the clinical benefits for patients. Methods An extensive search of Medline from 1985 to 2006 retrieved all trials including the keywords osteoporosis, compliance, persistence or adherence followed by a critical appraisal of the data obtained through a consensus expert meeting. Results The impact of non-adherence on the clinical development of interventions is reviewed, so that clinicians, regulatory agencies and reimbursement agencies might be better informed of the problem, in order to stimulate the necessary research to document adherence. Conclusion Adherence to therapy is a major problem in the treatment of osteoporosis. Both patients and medication factors are involved. Adherence studies are an important aspect of outcomes studies, but study methodologies are not well developed at the moment and should be improved. Performing adherence studies will be stimulated when registration authorities accept the result of these studies and include the relevant information in Sect. 5.1 of the summary of product characteristics. Reimbursement authorities might also consider such studies as important information for decisions on reimbursement. [less ▲]

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See detailUndertreatment with anti-osteoporotic drugs after hip fracture
Rabenda, Véronique ULiege; Fabri, Valérie; Mertens, Raf et al

in Arthritis and Rheumatism (2007, September), 56(number 9 (suppl.)), 614

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See detailImpact of poor adherence to bisphosphonates therapy on hip fracture risk in osteoporotic women
Rabenda, Véronique ULiege; Fabri, Véronique; Mertens, Raf et al

in Arthritis and Rheumatism (2007, September), 56(number 9 (suppl.)), 271

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See detailFlurbiprofen in the symptomatic management of rheumatoid arthritis: a valuable alternative
Richy, F.; Rabenda, Véronique ULiege; Mawet, Audrey ULiege et al

in International Journal of Clinical Practice (2007), 61(8), 1396-1406

Background: The withdrawal of certain cyclooxygenase-2 selective drugs and the availability of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) have increased the pressure for researching ... [more ▼]

Background: The withdrawal of certain cyclooxygenase-2 selective drugs and the availability of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) have increased the pressure for researching and prescribing conventional NSAIDs with a favourable efficacy/tolerance ratio in inflammatory diseases, particularly rheumatoid arthritis. The aim of this comprehensive meta-analysis was to evaluate the absolute and relative efficacy and safety of flurbiprofen in the management of rheumatoid arthritis. Methods: A systematic and exhaustive bibliographic research of published literature has been performed. The inclusion criteria are summarised as follows: randomised trial and rheumatoid arthritis and flurbiprofen and oral administration and anti-inflammatory doses from 100 to 300 mg and (placebo or aspirin or indomethacin or naproxen or ibuprofen or ketoprofen) and (articular pain or stiffness or swelling or mobility or patient/physician reported efficacy or tolerance or gastrointestinal (GI) tolerance). Studies were conducted from January 1975 to January 2006. Analyses have been stratified by comparisons and outcomes. Publication bias and robustness have been extensively investigated. Results: Fourteen studies, accounting for 1103 patient-years, have been included in the quantitative review. The mean daily doses administrated were 200 mg flurbiprofen, 4000 mg aspirin, 150 indomethacin, 750 mg naproxen and 1800 mg ibuprofen. Flurbiprofen was superior to placebo for all outcomes, and superior to three of four other NSAIDs in terms of formal symptomatic measures (pain, stiffness and swelling). Several patients or physicians reported the efficacy of flurbiprofen as superior to indomethacin and naproxen, while its safety, and particularly its GI tolerance were better compared with aspirin and indomethacin. Sensitivity analyses have reported a sufficient robustness against systematic publication bias assumptions. Conclusions: This meta-analysis has shown that flurbiprofen is an interesting alternative to commonly prescribed NSAIDs in the symptomatic management of rheumatoid arthritis, especially given its favourable efficacy/tolerance ratio. [less ▲]

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See detailLow incidence of osteoporosis treatment after hip fracture
Rabenda, Véronique ULiege; Mertens, Raf; Fabri, Valérie et al

in Osteoporosis International (2007, March), 18(Suppl.1), 72-73

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See detailAdherence to bisphosphonates therapy and hip fracture risk in osteoporotic women
Rabenda, Véronique ULiege; Reginster, Jean-Yves ULiege

in Osteoporosis International (2007, March), 18(Suppl.1), 19-20

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See detailPrevalence and impact of osteoarthritis and osteoporosis on health-related quality of life among active subjects
Rabenda, Véronique ULiege; Manette, Christelle; Lemmens, R. et al

in Aging Clinical & Experimental Research (2007), 19(1), 55-60

Background and aims: To assess the prevalence and impact of osteoarthritis (OA) and osteoporosis (OP) on health-related quality of life (HRQOL) among active subjects employed in the public workforce in ... [more ▼]

Background and aims: To assess the prevalence and impact of osteoarthritis (OA) and osteoporosis (OP) on health-related quality of life (HRQOL) among active subjects employed in the public workforce in Belgium. Methods: A cohort of 3440 subjects employed by the Liege City Council was prospectively followed for 6 months. The employees were asked to fill in a monthly log in a health record book, of data regarding their healthcare consumption due to OA and OP. HRQOL was assessed using the Medical Outcomes Study Short Form-36 (SF-36). Results: 1811 subjects (52.6%) filled in at least one questionnaire. The mean duration of follow-up was 3.46 months. The self-reported prevalence of OA and OP at entry to the study were respectively 34.1% and 5.3%. 3.6% of subjects reported suffering from both OA and OP. Subjects with OA and both OA and OP had significantly lower scores on all SF-36 dimensions compared with normal subjects, reflecting a worse HRQOL. The OP group had significantly lower mean scores for physical functioning and pain compared with controls. Subjects with both OA and OP had significantly lower values for physical functioning, physical role and pain when compared with the OA and OP groups. Conclusions: The results of this survey of a large sample of active subjects show that self-reported osteoarthritis and osteoporosis are common in the workplace. Both diseases have a major impact on health-related quality of life compared with that of people without self-reported musculoskeletal diseases. [less ▲]

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See detailThe direct and indirect costs of the chronic management of osteoporosis: a prospective follow-up of 3440 active subjects
Rabenda, Véronique ULiege; Manette, C.; Lemmens, R. et al

in Osteoporosis International (2006), 17(9), 1346-1352

Introduction: The objective of this study was to estimate the direct and indirect costs attributable to osteoporosis (OP) from a societal and a payer's perspective among active subjects living in Belgium ... [more ▼]

Introduction: The objective of this study was to estimate the direct and indirect costs attributable to osteoporosis (OP) from a societal and a payer's perspective among active subjects living in Belgium and employed in the public workforce. Materials and methods: A cohort of 3440 subjects employed by the Liege City Council was followed for 6 months. The City Council employees were invited to fill a monthly log of the data related to their utilization of health resources ( contacts with health professionals, medical examinations, drug use,...) due to OP. Information on work disability ( number of days of sick leave) and on informal care ( number of days off work incurred by active subjects in helping relatives or friends suffering from OP) was also collected. Results: Of those asked to participate in the study, 1,811 subjects filled in at least one questionnaire. The mean duration of follow-up was 3.46 months. Self-reported prevalence of OP at inclusion was 5.3%. OP subjects were significantly older (52.7 +/- 6.1 years) than normal subjects (45.5 +/- 9.8 years) ( p< 0.05) and included more women (85.3 vs. 55.9%). Direct costs came to E44.6 per OP patient-month: E10.9 was spent on contact with health professionals, E19.0 on medical examinations, E12.1 on drugs and E2.6 on hospitalizations. During this 6-month study, a total of 140 days of sick leave was recorded ( mean: 0.4 per OP patient-month). From a payer's perspective, this loss in productivity yielded a mean cost of E34.05 per OP patient-month. A mean number of days off work of 0.018 per active subject-month, attributable to informal care, was recorded. These days of inactivity represented, for the employer, a mean cost of E1.8 per active subject-month. Conclusion: The results of this survey of a large sample of active subjects confirm that OP-related expenditures, both for medical care and for loss of productivity, are significant. [less ▲]

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See detailDeterminants of gastro-protective drugs co-prescription during treatment with nonselective NSAIDs: a prospective survey of 2197 patients recruited in primary care
Rabenda, Véronique ULiege; Burlet, N.; Belaiche, Jacques ULiege et al

in Osteoarthritis and Cartilage (2006), 14(7), 625-630

Objective: Our goal was to identify the magnitude of gastro-protective drugs (GPDs) co-prescription and the profile of patients who received GPD co-prescription, during nonsteroidal anti-inflammatory ... [more ▼]

Objective: Our goal was to identify the magnitude of gastro-protective drugs (GPDs) co-prescription and the profile of patients who received GPD co-prescription, during nonsteroidal anti-inflammatory drugs (NSAIDs) treatment in a "real life setting" of primary care practice. Methods: A pragmatic prospective 6-month survey of 2197 new takers of nonselective NSAIDs, selected and followed by general practitioners (GPs) on the bias of their usual standards of care. Results: Forty-seven percent of our survey population used at least one GPD during the 6-month follow-up. No difference was identified between piroxicam, diclofenac, ibuprofen, meloxicam and nimesulid for the GPD co-prescription. Besides the presence of gastro-intestinal (GI) symptoms, previous use of GPD, previous occurrence of GI disorders and increase in age are the most prominent predictive factors of GPD use during NSAID treatment. When adjusted for other risk factors, co-prescription of GPD was significantly increased in patients aged 55 years and above (odds ratio (OR): 1.29, 95% confidence interval (Cl): 1.01-1.64) with no further increase in the co-prescription in older subjects. Conclusion: Patients above 55 years with previous history of GI symptoms or GPD use are more likely to benefit from cytoprotective medications. (C) 2006 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved. [less ▲]

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See detailDirect and indirect costs attributable to osteoarthritis in active subjects
Rabenda, Véronique ULiege; Manette, C.; Lemmens, R. et al

in Journal of Rheumatology (2006), 33(6), 1152-1158

OBJECTIVE: To estimate the direct and indirect costs of osteoarthritis (OA) in an active population, and to identify factors significantly influencing these expenditures. METHODS: A cohort of 3,440 ... [more ▼]

OBJECTIVE: To estimate the direct and indirect costs of osteoarthritis (OA) in an active population, and to identify factors significantly influencing these expenditures. METHODS: A cohort of 3,440 subjects employed by the Liege City Council was followed prospectively for 6 months. Subjects were asked to report monthly OA related health resource utilization (contacts with health professionals, medical examinations, drug consumption, etc.) and absence from work. Health related quality of life (HRQOL) was evaluated at baseline using the Medical Outcomes Study Short-form 36 (SF-36). Logistic regression analysis identified factors associated with the probability that the individual incurred costs, and multiple regression identified factors influencing the magnitude of these costs. RESULTS: A total of 1,811 subjects filled in at least one questionnaire (response rate 52%). The mean duration of followup was 3.46 months. Self-reported prevalence of OA was 34.1%. The mean total direct costs were 44.5 euros per OA patient-month. Contacts with health professionals, medical examinations, drugs, and hospital stays accounted for 23.7 euros, 8.7 euros, 6.7 euros, and 4.9 euros, respectively, per OA patient-month. The average number of sick-leave days was 0.8 per OA patient-month. From a payer's perspective, this loss of productivity represented a mean cost of 64.5 euros per OA patient-month. We also recorded 0.02 mean days off work per active subject-month due to informal care by relatives, yielding a mean cost of 1.8 euro per active subject-month for the employer. Poorer scores for most of the dimensions of the SF-36 at baseline were significantly associated with greater likelihood of incurring direct and indirect costs and with higher costs among subjects who reported costs. If we consider the overall cohort of active subjects, the burden of OA related to the direct and indirect costs was 15.2 euros and 23.8 euros, respectively, per active subject-month. CONCLUSION: Direct and indirect costs attributable to OA are substantial, with productivity related costs being predominant. Poorer HRQOL was a major determinant of these expenditures. [less ▲]

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See detailAdherence, patient preference and dosing frequency: Understanding the relationship
Reginster, Jean-Yves ULiege; Rabenda, Véronique ULiege; Neuprez, A.

in BONE (2006), 38(4 Suppl 1), 2-6

Adherence to treatment among patients with chronic diseases is currently suboptimal. Poor adherence leads to reduced clinical benefit, a raised incidence of secondary complications and therefore increased ... [more ▼]

Adherence to treatment among patients with chronic diseases is currently suboptimal. Poor adherence leads to reduced clinical benefit, a raised incidence of secondary complications and therefore increased healthcare costs. For patients with osteoporosis, long-term adherence to therapy is further complicated by the asymptomatic nature of the disease and the lack of options for patient self-monitoring. Bone densitometry and biochemical markers of bone turnover are assessments that could be used by physicians to provide feedback to patients on the effectiveness of medication. However, these feedback systems are costly and not readily available. Oral bisphosphonates are currently the first-line therapy for postmenopausal osteoporosis. However, they are associated with stringent dosing procedures, and some patients may experience upper gastrointestinal side-effects following administration. Alarmingly, approximately 50% of patients discontinue daily bisphosphonate therapy within 1 year, which negatively impacts upon treatment outcomes, leading to a reduced antifracture effect. Thus, there is a need for an effective therapy that enhances patient adherence. The impact of reducing bisphosphonate dosing frequency on therapeutic adherence has been documented in several studies. Data have shown that, although weekly dosing improves adherence compared with daily administration, levels are still suboptimal. Results from two recent studies that have assessed patient preference for a once-monthly compared with a weekly dosing schedule have demonstrated that patients prefer a monthly regimen (67-71%). Their reasons for preferring once-monthly dosing were that it would fit better with their lifestyle (49-77%) and would be more convenient (75%). A novel once-monthly bisphosphonate regimen, such as the ibandronate regimen, may therefore help patients to follow dosing guidelines and encourage them to stay on therapy longer, thereby improving overall therapy effectiveness. [less ▲]

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See detailPatient Preference in the Management of Postmenopausal Osteoporosis with Bisphosphonates
Reginster, Jean-Yves ULiege; Rabenda, Véronique ULiege

in Clinical Interventions in Aging (2006), 1(4), 415-23

The leading treatments for postmenopausal osteoporosis are the nitrogen-containing bisphosphonates, which are required long term for optimal benefit. Oral bisphosphonates have proven efficacy in ... [more ▼]

The leading treatments for postmenopausal osteoporosis are the nitrogen-containing bisphosphonates, which are required long term for optimal benefit. Oral bisphosphonates have proven efficacy in postmenopausal osteoporosis in clinical trials, but in practice the therapeutic benefits are often compromised by patients' low adherence. Nonadherence to bisphosphonate therapy negatively impacts outcomes such as fracture rate; fractures are in turn associated with decreased quality of life. The most common reason cited by patients for their nonadherence is that the strict dosing instructions for bisphosphonates are difficult to follow. One aspect of bisphosphonate administration that can be changed is dosing frequency and several studies have evaluated patient preferences for different dosing schedules. Studies have shown a preference for a weekly bisphosphonate regimen versus daily dosing and it has been demonstrated that this preference for reduced dosing frequency impacts on adherence. Ibandronate is the first nitrogen-containing oral bisphosphonate for osteoporosis that can be administered in a monthly regimen and two robust clinical studies demonstrated a strong patient preference for this monthly regimen versus a weekly regimen. It is important that physicians consider patient preference when prescribing treatment for osteoporosis to ensure that the disease is effectively managed for the long-term benefit of the patient. [less ▲]

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See detailAdherence to anti-osteoporotic treatment: does it really matter?
Reginster, Jean-Yves ULiege; Rabenda, Véronique ULiege

in Future Rheumatology (2006), 1

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See detailObservance et persistance: impact sur l'efficience des traitements de l'osteoporose
Reginster, Jean-Yves ULiege; Rabenda, Véronique ULiege

in Revue Médicale Suisse (2005), 1(35), 2278-81

Low adherence to therapies has been repeatedly described as a major determinant of poor clinical outcomes in chronic disorders. Bisphosphonates, the most widely prescribed drugs in this field, have been ... [more ▼]

Low adherence to therapies has been repeatedly described as a major determinant of poor clinical outcomes in chronic disorders. Bisphosphonates, the most widely prescribed drugs in this field, have been linked to a 12-month persistence lower than 40%. The situation is improved when using the weekly formulation compared to the daily intake of the drug. Low compliance results in lesser increase in bone mineral density and decreased anti-fracture efficacy. New medications, currently developed for the management of osteoporosis, will be user-friendly, allowing to an improvement of compliance and persistence. [less ▲]

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See detailGlobal prevalence and skeletal implications of vitamin D inadequacy
Reginster, Jean-Yves ULiege; Richy, Florent; Rabenda, Véronique ULiege et al

in Annals of the Rheumatic Diseases (2005, June), 64(Suppl.III), 362

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