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How the knowledge of fracture risk might influence adherence to oral therapy of osteoporosis in Italy: the ADEOST study

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Abstract

Summary

The patients’ adherence to osteoporosis treatments is low. In our study population a history of osteoporotic fractures was associated to better compliance and persistence; however, a 12-month randomized study carried out on 816 osteoporotic women showed that providing the patients with their individual fracture risk information did not prove effective.

Purpose

Several drugs are currently available for the treatment of osteoporosis, but the patients’ compliance and persistence with these treatments are low. This study aimed to both analyze the adherence to oral osteoporosis medications among Italian osteoporotic patients (cross-sectional study) and evaluate if providing patients with their individual fracture risk information may improve compliance and persistence (prospective study).

Methods

A total of 3379 osteoporotic patients referred as outpatients for a visit 1 year after receiving a prescription of oral osteoporosis medications for the first time, were enrolled for the retrospective study. Moreover, 816 postmenopausal women receiving an oral prescription for osteoporosis for the first time, were randomized into two groups: group 1 (managed according to standard clinical practice) and group 2 (managed with greater patient involvement and information on the individual risk of major osteoporotic fractures calculated by DeFRA algorithm).

Results

In the retrospective study, a history of osteoporotic fractures, the frequency of drug administration and a condition of being overweight/obese had a significant influence on both compliance and persistence. Of the 816 patients enrolled in the longitudinal study, 731 (374 of group 1 and 357 of group 2) attended the 1 year follow-up visit. The percentage of women with high compliance or persistence was greater in group 2 (64.2 vs. 58.1 % and 66.8 vs. 62.6 %, respectively), but without reaching any statistical significance.

Conclusions

Although providing the patients with their individual fracture risk information was not statistically effective, further studies on additional interventions able to improve the patients’ perceived risk of fracture are warranted.

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Authors and Affiliations

  1. Department of Medicine, Surgery and Neurosciences, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy

    Stefano Gonnelli, Carla Caffarelli & Ranuccio Nuti

  2. Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy

    Stefania Rossi

  3. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    Ombretta Di Munno

  4. Rheumatology, Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy

    Nazzarena Malavolta

  5. Gerontology Section, Department of Medical Science, University of Torino, Turin, Italy

    Giancarlo Isaia

  6. Department of Rheumatology, Hospital Galateo, San Cesario di Lecce, Italy

    Maurizio Muratore

  7. Rheumatology Unit, AUSL 3, Catania, Italy

    Giovanni D’Avola

  8. Department of Orthopedics and Traumatology, University of Salerno, Salerno, Italy

    Salvatore Gatto

  9. Ospedale di Alta Specializzazione San Camillo, Rome, Italy

    Giovanni Minisola

Authors
  1. Stefano Gonnelli
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Corresponding author

Correspondence to Stefano Gonnelli.

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Conflict of interest

On behalf of all authors, I declare no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration. Procedures performed in this study did not involve animals.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Gonnelli, S., Caffarelli, C., Rossi, S. et al. How the knowledge of fracture risk might influence adherence to oral therapy of osteoporosis in Italy: the ADEOST study. Aging Clin Exp Res 28, 459–468 (2016). https://doi.org/10.1007/s40520-016-0538-1

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  • DOI: https://doi.org/10.1007/s40520-016-0538-1

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