Skip to main content

Advertisement

Log in

Medication persistence in older women with osteoporosis: a pilot study

  • Short Communication
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

Most osteoporosis patients stop their medications before they should. Side effects are the most common reason patients in this sample stopped their medication before they told their physician. Physicians should use shared decision-making and discuss side effects of osteoporosis medications with their patients and explain the risks of the medications.

Introduction

The aims of this study were to (a) qualitatively examine reasons for medication non-persistence in osteoporosis, and (b) investigate how medication non-persistence in osteoporosis is associated with outcome expectations, self-efficacy, trust in physicians, and health locus of control.

Methods

Subjects were recruited from online support groups to answer an anonymous online survey. Subjects were eligible if they (a) were female, (b) were at least 40 years of age, (c) self-identify as having osteoporosis, and (d) have taken at least one medication for osteoporosis. During the survey, subjects completed measures of self-efficacy, outcome expectations, trust in physicians generally, health locus of control, and demographic information.

Results

Thirty-four subjects completed the online survey and had usable data. Approximately 82 % (n = 28) of subjects reported discontinuing an osteoporosis medication without first consulting a physician. The most common reason patients discontinued an osteoporosis medication was adverse effects. Subjects were more likely to discontinue their medications when they had poorer outcome expectations on average (p = 0.01), had lower trust in physicians on average (p < 0.0001), and had more of a doctors-centered locus of control (p = 0.03). Self-efficacy, age, insurance, status, and other measures of locus of control were not associated with medication non-persistence.

Conclusions

Side effects are a significant concern for women with osteoporosis and may be a cause for medication non-persistence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

References

  1. National Osteoporosis Foundation (2014) Clinician’s guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington

    Google Scholar 

  2. Centers for Disease Control and Prevention (2013) Osteoporosis FastStats. http://www.cdc.gov/nchs/fastats/osteoporosis.htm. Accessed 19 Jun 2014

  3. Tomkova S, Telepkova D, Vanuga P et al (2014) Therapeutic adherence to osteoporosis treatment. Int J Clin Pharmacol Ther. doi:10.5414/CP202072

    PubMed  Google Scholar 

  4. Netelenbos JC, Geusens PP, Ypma G, Buijs SJ (2011) Adherence and profile of non-persistence in patients treated for osteoporosis-a large-scale, long-term retrospective study in the Netherlands. Osteoporos Int 22:1537–1546

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Cramer JA, Gold DT, Silverman SL, Lewiecki EM (2007) A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos Int 18:1023–1031

    Article  CAS  PubMed  Google Scholar 

  6. Li L, Roddam A, Ferguson S, Feudjo-Tepie M, Taylor A, Jick S (2014) Switch patterns of osteoporosis medication and its impact on persistence among postmenopausal women in the UK General Practice Research Database. Menopause

  7. Salter C, McDaid L, Bhattacharya D et al (2014) Abandoned acid? Understanding adherence to bisphosphonate medications for the prevention of osteoporosis among older women: a qualitative longitudinal study. PLoS One 9:e83552. doi:10.1371/journal.pone.0083552

    Article  PubMed Central  PubMed  Google Scholar 

  8. Sakai A, Ikeda S, Okimoto N et al (2014) Clinical efficacy and treatment persistence of monthly minodronate for osteoporotic patients unsatisfied with, and shifted from, daily or weekly bisphosphonates: the BP-MUSASHI study. Osteoporos Int. doi:10.1007/s00198-014-2756-8

    PubMed  Google Scholar 

  9. Blume SW, Curtis JR (2011) Medical costs of osteoporosis in the elderly medicare population. Osteoporos Int 22:1835–1844

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Modi A, Sajjan S, Gandhi S (2014) Challenges in implementing and maintaining osteoporosis therapy. Int J Womens Health 13:759–769

    Article  Google Scholar 

  11. Yarom N, Yahalom R, Shosshani Y, et al (2007) Osteonecrosis of the jaw induced by orally administered bisphosphonates: incidence, clinical features, predisposing factors, and treatment outcome. Osteoporos Int. doi:10.1007/s00198-007-0384-2

  12. Leung S, Ashar BH, Miller RG (2005) Bisphosphonates-associated scleritis: a case report and a review. South Med J 98:733–735

    Article  PubMed  Google Scholar 

  13. Corrado A, Santoro N, Cantatore FP (2007) Extra-skeletal effects of bisphosphonates. Joint Bone Spine 74:32–38

    Article  CAS  PubMed  Google Scholar 

  14. Baranowski T, Perry CL, Parcel GS (2008) How individuals, environments, and health behavior interact: social cognitive theory. In: Glanz K, Rimer BK, Lewis FM (eds) Health Behavior and Health Education. John Wiley and Sons, Hoboken, pp 169–188

    Google Scholar 

  15. Nahm ES, Barker B, Resnick B et al (2010) Effects of a social cognitive theory-based hip fracture prevention web site for older adults. Comput Inform Nurs 28:371–379

    Article  PubMed Central  PubMed  Google Scholar 

  16. Hall MA, Camacho F, Dugan E, Balkrishnan (2002) Trust in the medical profession: conceptual and measurement issues. Health Serv Res 37:1436–1439

    Article  Google Scholar 

  17. Resnick B, Wehren L, Orwig D (2003) Reliability and validity of the self-efficacy and outcome expectations for osteoporosis medication adherence scales. Orthop Nurs 22:139–147

    Article  PubMed  Google Scholar 

  18. Wallston KA. Multidimensional health locus of control (MHLC) (2003) Scales website. http://www.nursing.vanderbilt.edu/faculty/kwallston/mhlcscales.htm. Accessed 16 Jun 2015

  19. Gillette C, Blalock SJ, Rao JK, Williams D, Loughlin C, Sleath B (2013) Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence. Pediatr Pulmonol. doi:10.002/ppul.22892

    PubMed  Google Scholar 

  20. Bieber C, Muller KG, Blumenstiel K et al (2006) Long-term effects of a shared decision-making intervention on physician-patient interaction and outcome in fibromyalgia: a qualitative and quantitative 1 year follow-up of a randomized controlled trial. Pat Educ Couns 63:357–366

    Article  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Gillette.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gillette, C., Howerton, D.M., Williams, B.D. et al. Medication persistence in older women with osteoporosis: a pilot study. Osteoporos Int 26, 2883–2888 (2015). https://doi.org/10.1007/s00198-015-3242-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-015-3242-7

Keywords

Navigation