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Table 3 Odds ratios (ORs) and 95% confidence intervals (CIs) for the association between precipitating factors and discontinueation of bisphosphonate therapy, case-crossover analysis

From: Patterns and predictors of osteoporosis medication discontinuation and switching among Medicare beneficiaries

Factors potentially associated with discontinuationa Univariate analysis Multivariate analysis
  OR (95% CI) AdjustedbOR (95% CI)
Dual-energy X-ray absorptiometry 2.0 (1.3-3.1) 2.3 (1.4-3.6)
Any hospitalization 2.2 (1.5-3.1) 1.7 (1.1-2.7)
Fracture 0.7 (0.2-1.9) 0.4 (0.1-1.3)
Cancer 1.2 (0.7-1.9) 1.0 (0.6-1.8)
Entering Medicare part D coverage gap 1.0 (0.8-1.3) 0.9 (0.7-1.3)
Adverse effects 1.6 (1.1-2.3) 1.0 (0.7-1.6)
Skilled nursing home 0.7 (0.2-2.1) 0.4 (0.1-1.4)
Rheumatologist or endocrinologist visit 1.1 (0.7-1.7) 0.8 (0.5-1.4)
Upper gastrointestinal disease 3.2 (1.4-7.3) 3.4 (1.5-7.7)
Eligible for low income subsidy 4.9 (0.8-28.7) 5.7 (1.0-32.4)
Number of ambulatory physician visits during each 30 day period   
0 Ref (1.0) Ref (1.0)
1-4 1.2 (1.0-1.4) 1.2 (1.0-1.5)
> 4 2.4 (1.4-4.1) 2.5 (1.3-4.5)
Number of medications during each 30 day period   
0-2 Ref (1.0) Ref (1.0)
3-5 0.8 (0.7-1.0) 0.5 (0.4-0.6)
> 5 0.5 (0.4-0.7) 0.3 (0.2-0.4)
Charlson score during each 30 day period   
0 Ref (1.0) Ref (1.0)
1-2 1.3 (0.8-1.9) 1.4 (0.9-2.1)
> 2 1.7 (1.0-3.1) 2.5 (1.3-4.7)
Total Medicare cost during each 30-day period   
$ 0-90 Ref (1.0) Ref (1.0)
$ 91-440 0.9 (0.7-1.1) 0.9 (0.7-1.1)
$ > 440 1.0 (0.8-1.3) 0.9 (0.8-1.3)
Out-of-pocket drug payments during each 30 day period   
$ 0-19 Ref (1.0) Ref (1.0)
$ 20-84 1.6 (1.2-2.0) 1.6 (1.3-2.1)
$ > 84 5.4 (4.4-6.7) 6.6 (5.3-8.1)
  1. aHazard period is defined as 30 days immediately before discontinuation. Control periods are defined as five 30-day periods immediately before the hazard period.
  2. bAdjusted all the factors listed in the table.