Osteoporosis International

, Volume 20, Issue 12, pp 2127–2134

Interventions to improve adherence and persistence with osteoporosis medications: a systematic literature review

Authors

  • T. Gleeson
    • Division of Rheumatology, Immunology, and Allergy, Department of MedicineBrigham and Women’s Hospital
  • M. D. Iversen
    • Division of Rheumatology, Immunology, and Allergy, Department of MedicineBrigham and Women’s Hospital
    • MGH Institute of Health Professions
  • J. Avorn
    • Division of Pharmacoepidemiology, Department of MedicineBrigham and Women’s Hospital
  • A. M. Brookhart
    • Division of Pharmacoepidemiology, Department of MedicineBrigham and Women’s Hospital
  • J. N. Katz
    • Division of Rheumatology, Immunology, and Allergy, Department of MedicineBrigham and Women’s Hospital
    • Department of Orthopedic SurgeryBrigham and Women’s Hospital
  • E. Losina
    • Division of Rheumatology, Immunology, and Allergy, Department of MedicineBrigham and Women’s Hospital
    • Department of Orthopedic SurgeryBrigham and Women’s Hospital
  • F. May
    • Division of Pharmacoepidemiology, Department of MedicineBrigham and Women’s Hospital
  • A. R. Patrick
    • Division of Pharmacoepidemiology, Department of MedicineBrigham and Women’s Hospital
  • W. H. Shrank
    • Division of Pharmacoepidemiology, Department of MedicineBrigham and Women’s Hospital
    • Division of Rheumatology, Immunology, and Allergy, Department of MedicineBrigham and Women’s Hospital
    • Division of Pharmacoepidemiology, Department of MedicineBrigham and Women’s Hospital
Review

DOI: 10.1007/s00198-009-0976-0

Cite this article as:
Gleeson, T., Iversen, M.D., Avorn, J. et al. Osteoporos Int (2009) 20: 2127. doi:10.1007/s00198-009-0976-0

Abstract

Summary

Adherence and persistence with osteoporosis medications are poor. We conducted a systematic literature review of interventions to improve adherence and persistence with osteoporosis medications. Seven studies met eligibility requirements and were included in the review. Few interventions were efficacious, and no clear trends regarding successful intervention techniques were identified. However, periodic follow-up interaction between patients and health professionals appeared to be beneficial.

Introduction

Adherence and persistence with pharmacologic therapy for osteoporosis are suboptimal. Our goal was to examine the design and efficacy of published interventions to improve adherence and persistence.

Methods

We searched medical literature databases for English-language papers published between January 1990 and July 2008. We selected papers that described interventions and provided results for control and intervention subjects. We assessed the design and methods of each study, including randomization, blinding, and reporting of drop-outs. We summarized the results and calculated effect sizes for each trial.

Results

Seven studies met eligibility requirements and were included in the review. Five of the seven studies provided adherence data. Of those five studies, three showed a statistically significant (p ≤ 0.05) improvement in adherence by the intervention group, with effect sizes from 0.17 to 0.58. Five of the seven studies provided persistence data. Of those five, one reported statistically significant improvement in persistence by the intervention group, with an effect size of 0.36.

Conclusions

Few interventions were efficacious, and no clear trends regarding successful intervention techniques were identified in this small sample of studies. However, periodic follow-up interaction between patients and health professionals appeared to be beneficial.

Keywords

AdherenceComplianceInterventionMedicationMotivational interviewingOsteoporosisPersistenceSystematic review

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009