Osteoporosis International

, Volume 23, Issue 2, pp 733–741 | Cite as

Treatment satisfaction and persistence among postmenopausal women on osteoporosis medications: 12-month results from POSSIBLE US™

  • E. Barrett-Connor
  • S. W. Wade
  • T. P. Do
  • S. Satram-Hoang
  • R. Stewart
  • G. Gao
  • D. Macarios
Original Article



Women in POSSIBLE US™ who expressed greater treatment satisfaction at study entry were more likely to persist with osteoporosis therapy over a 1-year period. Lower satisfaction among women with moderate/severe side effects increased the risk of discontinuation/switching by 67%. Treatment satisfaction and side effect experience influence osteoporosis medication adherence.


Non-adherence is common among women using postmenopausal osteoporosis (PMO) medications. We describe the association between treatment satisfaction, measured with the Treatment Satisfaction Questionnaire for Medication (TSQM), and the risk of discontinuation/switching PMO medications using patient-reported data from a large, longitudinal cohort study.


Data from 2,405 participants in the Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBLE US™) Study were evaluated. Cox proportional hazards regression was used to estimate hazard ratios (HR) for the association between treatment satisfaction at study entry and self-reported discontinuation/switching of pharmacologic PMO medications over a 1-year follow-up period. Logistic regression was used to evaluate relationships between treatment satisfaction, lifestyle behaviors, and compliance with bisphosphonate dosing instructions.


Median TSQM scores were highest (indicating greatest satisfaction) for the side effects domain [n = 1,182; median = 87.5 (Q1 = 75.0, Q3 = 100.0)] and lowest for global satisfaction [n = 2,340; median = 64.0 (Q1 = 55.7, Q3 = 77.7)]. Median scores decreased for the side effects and global satisfaction domains as patient-reported side effect severity increased. Women with higher satisfaction were less likely to discontinue/switch medications than women with lower scores (adjusted HRs for convenience 0.73, 95% CI = 0.63–0.85; effectiveness 0.82, 95% CI = 0.70–0.97; and global satisfaction 0.73, 95% CI = 0.63–0.85). Lower treatment satisfaction was particularly influential among women who reported moderate/severe side effects (HR = 0.60, 95% CI = 0.37–0.97).


Lower treatment satisfaction was associated with a 22% (1/0.82) to 67% (1/0.60) increased risk of discontinuation/switching osteoporosis medication during 1 year of follow-up.


Discontinuation Medication Postmenopausal osteoporosis Switching Treatment satisfaction 



The authors would like to acknowledge the other members of the POSSIBLE US™ Steering Committee: Robert Downs, Ted Ganiats, Marc Hochberg, Barbara Lukert, Robert Recker, Robert Rubin and Anna Tosteson. We would also like to acknowledge the REGISTRAT, Inc. staff members who assisted with the implementation of this study and ongoing data collection, as well as Sue Hudson, who provided editorial assistance on behalf of Amgen Inc. Funding for this study was provided by Amgen Inc., Thousand Oaks, CA USA.

Conflicts of interest

E. Barrett-Connor receives support from Amgen, Inc. for serving as Chair of the POSSIBLE US™ Study Steering Committee; she is an investigator on clinical trials for Arena Pharmaceuticals, Boehringer Ingelheim, Merck, Pfizer and Roche. Dr. Barrett-Connor also receives grant funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR), and NIH Roadmap for Medical Research. S. Wade and S. Satram-Hoang provide consulting services to Amgen Inc. T. P. Do, R. Stewart, G. Gao, and D. Macarios are employees of Amgen Inc. and have received Amgen stock/stock options.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • E. Barrett-Connor
    • 1
  • S. W. Wade
    • 2
  • T. P. Do
    • 3
  • S. Satram-Hoang
    • 3
  • R. Stewart
    • 3
  • G. Gao
    • 3
  • D. Macarios
    • 3
  1. 1.Division of Epidemiology, Department of Family and Preventive MedicineSchool of Medicine, University of California San DiegoLa JollaUSA
  2. 2.Wade Outcomes Research and ConsultingSalt Lake CityUSA
  3. 3.Amgen Inc.Thousand OaksUSA

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