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KMID : 1100120160230020079
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대한골대사학회지
2016 Volume.23 No. 2 p.79 ~ p.83
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Which Bisphosphonate? It's the Compliance!: Decision Analysis
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Lee You-Jin
Park Chan-Ho
Lee Young-Kyun
Ha Yong-Chan
Koo Kyung-Hoi
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Abstract
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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.
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KEYWORD
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Diphosphonates, Fractures bone, Osteoporosis postmenopausal, Patient compliance
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