Drugs & Aging

, Volume 24, Issue 1, pp 37–55 | Cite as

Patient Adherence to Osteoporosis Medications

Problems, Consequences and Management Strategies
  • Alexandra Papaioannou
  • Courtney C. Kennedy
  • Lisa Dolovich
  • Elaine Lau
  • Jonathan D. Adachi
Review Article

Abstract

Adherence to osteoporosis medications is relatively poor. Approximately 20–30% of patients taking daily or weekly treatments may suspend their treatment within 6 to 12 months of initiating therapy. Patients with poor adherence increase their risk of osteoporotic fractures and hospitalisation. The majority of patients who discontinue therapy appear to do so because of drug-induced adverse effects. Fear of adverse effects or other health risks is another commonly cited reason for discontinuing therapy. Factors associated with medication adherence include fractures, regular exercise, female sex, fewer non-osteoporosis medications and co-morbidities, early menopause, willingness to take medications, awareness of osteoporosis status based on a diagnostic test, anti-inflammatory therapy and corticosteroid therapy. Factors associated with non-adherence include adverse effects, pain and being unsure about bone mineral density (BMD) test results. Bisphosphonates, a common class of drugs for treating osteoporosis, have specific administration requirements (e.g. fasting, remaining upright and not ingesting other medications concomitantly). Patient surveys indicate that 12–18% of patients report non-compliance with at least one administration rule. Strategies to increase adherence include reducing administration frequency to weekly or monthly, monitoring patients with bone markers and BMD testing, providing adequate instructions, practitioner feedback and support, and educational materials and sessions. Future studies are needed regarding strategies to increase adherence to osteoporosis medications.

Notes

Acknowledgements

JD Adachi has acted as a consultant for and/or received honoraria from Amgen, Astra Zeneca, sanofi-aventis, Eli Lilly, GlaxoSmithKline, Merck, Novartis, NPS Allelix, Pfizer, Procter & Gamble, Roche, Servier, Wyeth.

Alexandra Papaioannou has acted as a consultant and received honoraria or grants from Eli Lilly, Merck Frosst Canada, Procter & Gamble Pharmaceuticals Canada and sanofi-aventis, and has acted as a consultant and received honoraria from Novartis.

Courtney Kennedy, Lisa Dolovich and Elaine Lau have no potential conflicts of interest of direct relevance to the content of this review.

No sources of funding were used to assist in the preparation of this review.

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Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Alexandra Papaioannou
    • 1
    • 2
  • Courtney C. Kennedy
    • 1
  • Lisa Dolovich
    • 1
    • 2
    • 3
  • Elaine Lau
    • 2
    • 3
  • Jonathan D. Adachi
    • 1
  1. 1.Department of MedicineMcMaster UniversityHamiltonCanada
  2. 2.The Team for Individualizing Pharmacotherapy in Primary Care for Senior (TIPPS)HamiltonCanada
  3. 3.Centre For Evaluation of MedicinesSt Joseph’s Healthcare Hamilton and McMaster University, Faculty of Health SciencesHamiltonCanada

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