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Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey

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Abstract

Objective

To determine the factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis.

Design

Cross-sectional survey.

Setting

National survey in the UK.

Participants

Participants were recruited through the National Osteoporosis Society and advertisements in the press and on the radio and included 533 women over age 50 with osteoporosis who were currently taking or had taken bisphosphonate therapy within the previous 12 months.

Main outcome measures

Self-reported factors influencing adherence and persistence to bisphosphonate therapy in osteoporosis: fracture history, pain, practical difficulties taking medication (frequency of dosing, dealing with comedications, impact on daily routine), perceptions of therapy, and concerns about bisphosphonate therapy.

Results

Adherence to bisphosphonate therapy was 48% and was associated with previous fracture [odds ratio (OR) 1.62, 95% confidence interval (CI) 1.14–3.02], concerns about medication (OR 1.49, 95% CI 1.01–2.20), and less dissatisfaction with medication (OR 0.65, 95% CI 0.44–0.97). Nonpersistence was associated with dissatisfaction with medication (hazard ratio (HR) 1.83, 95% CI 1.38–2.43), side effects (HR 3.69, 95% CI 2.74–4.97), and concerns about bisphosphonate therapy (HR 2.21, 95% CI 1.48–3.30). For both daily (HR 1.53, 95% CI 1.1–2.33) and weekly bisphosphonates (HR 1.90, 95% CI 1.17–3.07), practical difficulties taking bisphosphonate medication—in particular, too frequent dosing—were associated with nonpersistence.

Conclusions

Self-reported nonadherence to daily and weekly bisphosphonates is independent of the decision to stop taking treatment (nonpersistence). Nonpersistence is associated with side effects and other factors that could be modified in clinical practice through education, information, and concordant partnerships.

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Funding

This study was funded by Roche Products and GlaxoSmithKline. The funders had no role in the day-to-day running of the study, the data analysis or interpretation, the drafting of the paper, or the decision to publish. The study was run by an independent clinical research company, Clinimatrix, in association with C.C. and P.W.T. Data were collected and analysed by Clinimatrix and reviewed and interpreted by C.C. and P.W.T. The authors were responsible for determining the content of the paper, writing the paper, and deciding when and where to publish. The funders had no role in these processes.

Declaration of competing interests

P.T. and C.C. have received consulting fees from Roche Products, Merck Sharp & Dohme, and Procter & Gamble, all manufacturers of competing bisphosphonates. A.C. has shares in Clinimatrix, the independent clinical research company that obtained funding for this study from Roche Products and GlaxoSmithKline.

Author information

Authors and Affiliations

  1. Academic Rheumatology, Nottingham University, Clinical Sciences Building, City Hospital, Nottingham, NG5 1PB, UK

    A. J. Carr

  2. Poole NHS Trust, Longfleet Road, Poole, Dorset, BH15 2JB, UK

    P. W. Thompson

  3. MRC Epidemiology Resource Centre, Southampton University Medical School, Tremona Road, Southampton, SO16 6YD, UK

    C. Cooper

  4. Clinimatrix, Hale House, Hale House Lane, Churt, Surrey, GU10 2JQ, UK

    A. J. Carr

Authors
  1. A. J. Carr
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  2. P. W. Thompson
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  3. C. Cooper
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Corresponding author

Correspondence to A. J. Carr.

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Carr, A.J., Thompson, P.W. & Cooper, C. Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey. Osteoporos Int 17, 1638–1644 (2006). https://doi.org/10.1007/s00198-006-0166-2

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  • DOI: https://doi.org/10.1007/s00198-006-0166-2

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