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Osteoporosis International
Published in: Osteoporosis International 11/2006

01-11-2006 | Original Article

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

Authors: A. J. Carr, P. W. Thompson, C. Cooper

Published in: Osteoporosis International | Issue 11/2006

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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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Metadata
Title
Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey
Authors
A. J. Carr
P. W. Thompson
C. Cooper
Publication date
01-11-2006
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 11/2006
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0166-2

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