Skip to main content
Top
Published in: Osteoporosis International 12/2018

01-12-2018 | Review Article

A systematic review of factors affecting medication adherence among patients with osteoporosis

Authors: C. T. Yeam, S. Chia, H. C. C. Tan, Y. H. Kwan, W. Fong, J. J. B. Seng

Published in: Osteoporosis International | Issue 12/2018

Login to get access

Abstract

Summary

The aim of this review was to identify factors that influence patients’ adherence to anti-osteoporotic therapy. Factors identified that were associated with poorer medication adherence included polypharmacy, older age, and misconceptions about osteoporosis. Physicians need to be aware of these factors so as to optimize therapeutic outcomes for patients.

Introduction

To identify factors that influence patients’ adherence to anti-osteoporotic therapy.

Methods

A systematic review of literature was performed for articles published up till January 2018 using PubMed®, PsychINFO®, Embase®, and CINAHL®. Peer-reviewed articles which examined factors associated with anti-osteoporotic medication adherence were included. Classes of anti-osteoporotic therapy included bisphosphonates, parathyroid hormone-related analogue, denosumab, selective estrogen receptor modulators, estrogen/progestin therapy, calcitonin, and strontium ranelate. Meta-analyses, case reports/series, and other systematic reviews were excluded. Identified factors were classified using the World Health Organization’s five dimensions of medication adherence (condition, patient, therapy, health-system, and socio-economic domains).

Results

Of 2404 articles reviewed, 124 relevant articles were identified. The prevalence of medication adherence ranged from 12.9 to 95.4%. Twenty-four factors with 139 sub-factors were identified. Bisphosphonates were the most well-studied class of medication (n = 59, 48%). Condition-related factors that were associated with poorer medication adherence included polypharmacy, and history of falls was associated with higher medication adherence. Patient-related factors which were associated with poorer medication adherence included older age and misconceptions about osteoporosis while therapy-related factors included higher dosing frequency and medication side effects. Health system-based factors associated with poorer medication adherence included care under different medical specialties and lack of patient education. Socio-economic-related factors associated with poorer medication adherence included current smoker and lack of medical insurance coverage.

Conclusion

This review identified factors associated with poor medication adherence among osteoporotic patients. To optimize therapeutic outcomes for patients, clinicians need to be aware of the complexity of factors affecting medication adherence.
Appendix
Available only for authorised users
Literature
3.
go back to reference Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7(5):407–413CrossRef Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7(5):407–413CrossRef
14.
go back to reference Burkhart PV, Sabate E (2003) Adherence to long-term therapies: evidence for action. J Nurs Scholarsh 35(3):207 Burkhart PV, Sabate E (2003) Adherence to long-term therapies: evidence for action. J Nurs Scholarsh 35(3):207
17.
go back to reference Fahrleitner-Pammer A, Papaioannou N, Gielen E, Feudjo Tepie M, Toffis C, Frieling I, Geusens P, Makras P, Boschitsch E, Callens J, Anastasilakis AD, Niedhart C, Resch H, Kalouche-Khalil L, Hadji P (2017) Factors associated with high 24-month persistence with denosumab: results of a real-world, non-interventional study of women with postmenopausal osteoporosis in Germany, Austria, Greece, and Belgium. Arch Osteoporos 12(1):58. https://doi.org/10.1007/s11657-017-0351-2 CrossRefPubMedPubMedCentral Fahrleitner-Pammer A, Papaioannou N, Gielen E, Feudjo Tepie M, Toffis C, Frieling I, Geusens P, Makras P, Boschitsch E, Callens J, Anastasilakis AD, Niedhart C, Resch H, Kalouche-Khalil L, Hadji P (2017) Factors associated with high 24-month persistence with denosumab: results of a real-world, non-interventional study of women with postmenopausal osteoporosis in Germany, Austria, Greece, and Belgium. Arch Osteoporos 12(1):58. https://​doi.​org/​10.​1007/​s11657-017-0351-2 CrossRefPubMedPubMedCentral
22.
go back to reference Hadji P, Papaioannou N, Gielen E, Feudjo Tepie M, Zhang E, Frieling I, Geusens P, Makras P, Resch H, Moller G, Kalouche-Khalil L, Fahrleitner-Pammer A (2015) Persistence, adherence, and medication-taking behavior in women with postmenopausal osteoporosis receiving denosumab in routine practice in Germany, Austria, Greece, and Belgium: 12-month results from a European non-interventional study. Osteoporos Int 26(10):2479–2489. https://doi.org/10.1007/s00198-015-3164-4 CrossRefPubMedPubMedCentral Hadji P, Papaioannou N, Gielen E, Feudjo Tepie M, Zhang E, Frieling I, Geusens P, Makras P, Resch H, Moller G, Kalouche-Khalil L, Fahrleitner-Pammer A (2015) Persistence, adherence, and medication-taking behavior in women with postmenopausal osteoporosis receiving denosumab in routine practice in Germany, Austria, Greece, and Belgium: 12-month results from a European non-interventional study. Osteoporos Int 26(10):2479–2489. https://​doi.​org/​10.​1007/​s00198-015-3164-4 CrossRefPubMedPubMedCentral
35.
go back to reference Papaioannou A, Ioannidis G, Adachi JD, Sebaldt RJ, Ferko N, Puglia M, Brown J, Tenenhouse A, Olszynski WP, Boulos P, Hanley DA, Josse R, Murray TM, Petrie A, Goldsmith CH (2003) Adherence to bisphosphonates and hormone replacement therapy in a tertiary care setting of patients in the CANDOO database. Osteoporos Int 14(10):808–813. https://doi.org/10.1007/s00198-003-1431-2 CrossRefPubMed Papaioannou A, Ioannidis G, Adachi JD, Sebaldt RJ, Ferko N, Puglia M, Brown J, Tenenhouse A, Olszynski WP, Boulos P, Hanley DA, Josse R, Murray TM, Petrie A, Goldsmith CH (2003) Adherence to bisphosphonates and hormone replacement therapy in a tertiary care setting of patients in the CANDOO database. Osteoporos Int 14(10):808–813. https://​doi.​org/​10.​1007/​s00198-003-1431-2 CrossRefPubMed
39.
go back to reference Abobului M, Berghea F, Vlad V, Balanescu A, Opris D, Bojinca V, Kosevoi Tichie A, Predeteanu D, Ionescu R (2015) Evaluation of adherence to anti-osteoporosis treatment from the socio-economic context. J Med Life 8(Spec Issue):119–123PubMedPubMedCentral Abobului M, Berghea F, Vlad V, Balanescu A, Opris D, Bojinca V, Kosevoi Tichie A, Predeteanu D, Ionescu R (2015) Evaluation of adherence to anti-osteoporosis treatment from the socio-economic context. J Med Life 8(Spec Issue):119–123PubMedPubMedCentral
42.
go back to reference Vestergaard P, Hermann AP, Gram J, Jensen LB, Kolthoff N, Abrahamsen B, Brot C, Eiken P (1997) Improving compliance with hormonal replacement therapy in primary osteoporosis prevention. Maturitas 28(2):137–145CrossRef Vestergaard P, Hermann AP, Gram J, Jensen LB, Kolthoff N, Abrahamsen B, Brot C, Eiken P (1997) Improving compliance with hormonal replacement therapy in primary osteoporosis prevention. Maturitas 28(2):137–145CrossRef
56.
go back to reference Modi A, Sen S, Adachi JD, Adami S, Cortet B, Cooper AL, Geusens P, Mellstrom D, Weaver JP, van den Bergh JP, Keown P, Sajjan S (2017) The impact of GI events on persistence and adherence to osteoporosis treatment: 3-, 6-, and 12-month findings in the MUSIC-OS study. Osteoporos Int. https://doi.org/10.1007/s00198-017-4271-1 CrossRef Modi A, Sen S, Adachi JD, Adami S, Cortet B, Cooper AL, Geusens P, Mellstrom D, Weaver JP, van den Bergh JP, Keown P, Sajjan S (2017) The impact of GI events on persistence and adherence to osteoporosis treatment: 3-, 6-, and 12-month findings in the MUSIC-OS study. Osteoporos Int. https://​doi.​org/​10.​1007/​s00198-017-4271-1 CrossRef
58.
go back to reference Silverman SL, Siris E, Kendler DL, Belazi D, Brown JP, Gold DT, Lewiecki EM, Papaioannou A, Simonelli C, Ferreira I, Balasubramanian A, Dakin P, Ho P, Siddhanti S, Stolshek B, Recknor C (2015) Persistence at 12 months with denosumab in postmenopausal women with osteoporosis: interim results from a prospective observational study. Osteoporos Int 26(1):361–372. https://doi.org/10.1007/s00198-014-2871-6 CrossRefPubMed Silverman SL, Siris E, Kendler DL, Belazi D, Brown JP, Gold DT, Lewiecki EM, Papaioannou A, Simonelli C, Ferreira I, Balasubramanian A, Dakin P, Ho P, Siddhanti S, Stolshek B, Recknor C (2015) Persistence at 12 months with denosumab in postmenopausal women with osteoporosis: interim results from a prospective observational study. Osteoporos Int 26(1):361–372. https://​doi.​org/​10.​1007/​s00198-014-2871-6 CrossRefPubMed
59.
go back to reference Sanfelix-Genoves J, Gil-Guillen VF, Orozco-Beltran D, Giner-Ruiz V, Pertusa-Martinez S, Reig-Moya B, Carratala C (2009) Determinant factors of osteoporosis patients’ reported therapeutic adherence to calcium and/or vitamin D supplements: a cross-sectional, observational study of postmenopausal women. Drugs Aging 26(10):861–869. https://doi.org/10.2165/11317070-000000000-00000 CrossRefPubMed Sanfelix-Genoves J, Gil-Guillen VF, Orozco-Beltran D, Giner-Ruiz V, Pertusa-Martinez S, Reig-Moya B, Carratala C (2009) Determinant factors of osteoporosis patients’ reported therapeutic adherence to calcium and/or vitamin D supplements: a cross-sectional, observational study of postmenopausal women. Drugs Aging 26(10):861–869. https://​doi.​org/​10.​2165/​11317070-000000000-00000 CrossRefPubMed
62.
go back to reference Jones TJ, Petrella RJ, Crilly R (2008) Determinants of persistence with weekly bisphosphonates in patients with osteoporosis. J Rheumatol 35(9):1865–1873PubMed Jones TJ, Petrella RJ, Crilly R (2008) Determinants of persistence with weekly bisphosphonates in patients with osteoporosis. J Rheumatol 35(9):1865–1873PubMed
66.
go back to reference Richards JS, Cannon GW, Hayden CL, Amdur RL, Lazaro D, Mikuls TR, Reimold AM, Caplan L, Johnson DS, Schwab P, Cherascu BN, Kerr GS (2012) Adherence with bisphosphonate therapy in US veterans with rheumatoid arthritis. Arthritis Care Res 64(12):1864–1870. https://doi.org/10.1002/acr.21777 CrossRef Richards JS, Cannon GW, Hayden CL, Amdur RL, Lazaro D, Mikuls TR, Reimold AM, Caplan L, Johnson DS, Schwab P, Cherascu BN, Kerr GS (2012) Adherence with bisphosphonate therapy in US veterans with rheumatoid arthritis. Arthritis Care Res 64(12):1864–1870. https://​doi.​org/​10.​1002/​acr.​21777 CrossRef
74.
go back to reference Segal E, Tamir A, Ish-Shalom S (2003) Compliance of osteoporotic patients with different treatment regimens. Isr Med Assoc J 5(12):859–862PubMed Segal E, Tamir A, Ish-Shalom S (2003) Compliance of osteoporotic patients with different treatment regimens. Isr Med Assoc J 5(12):859–862PubMed
77.
go back to reference Casula M, Catapano AL, Piccinelli R, Menditto E, Manzoli L, De Fendi L, Orlando V, Flacco ME, Gambera M, Filippi A, Tragni E (2014) Assessment and potential determinants of compliance and persistence to antiosteoporosis therapy in Italy. Am J Manag Care 20(5):e138–e145PubMed Casula M, Catapano AL, Piccinelli R, Menditto E, Manzoli L, De Fendi L, Orlando V, Flacco ME, Gambera M, Filippi A, Tragni E (2014) Assessment and potential determinants of compliance and persistence to antiosteoporosis therapy in Italy. Am J Manag Care 20(5):e138–e145PubMed
84.
89.
97.
go back to reference Lewiecki EM, Babbitt AM, Piziak VK, Ozturk ZE, Bone HG (2008) Adherence to and gastrointestinal tolerability of monthly oral or quarterly intravenous ibandronate therapy in women with previous intolerance to oral bisphosphonates: a 12-month, open-label, prospective evaluation. Clin Ther 30(4):605–621CrossRef Lewiecki EM, Babbitt AM, Piziak VK, Ozturk ZE, Bone HG (2008) Adherence to and gastrointestinal tolerability of monthly oral or quarterly intravenous ibandronate therapy in women with previous intolerance to oral bisphosphonates: a 12-month, open-label, prospective evaluation. Clin Ther 30(4):605–621CrossRef
98.
go back to reference Kertes J, Dushenat M, Vesterman JL, Lemberger J, Bregman J, Friedman N (2008) Factors contributing to compliance with osteoporosis medication. Isr Med Assoc J 10(3):207–213PubMed Kertes J, Dushenat M, Vesterman JL, Lemberger J, Bregman J, Friedman N (2008) Factors contributing to compliance with osteoporosis medication. Isr Med Assoc J 10(3):207–213PubMed
99.
go back to reference Blotman F, Cortet B, Hilliquin P, Avouac B, Allaert FA, Pouchain D, Gaudin AF, Cotte FE, El Hasnaoui A (2007) Characterisation of patients with postmenopausal osteoporosis in French primary healthcare. Drugs Aging 24(7):603–614CrossRef Blotman F, Cortet B, Hilliquin P, Avouac B, Allaert FA, Pouchain D, Gaudin AF, Cotte FE, El Hasnaoui A (2007) Characterisation of patients with postmenopausal osteoporosis in French primary healthcare. Drugs Aging 24(7):603–614CrossRef
110.
go back to reference Lau E, Papaioannou A, Dolovich L, Adachi J, Sawka AM, Burns S, Nair K, Pathak A (2008) Patients’ adherence to osteoporosis therapy: exploring the perceptions of postmenopausal women. Can Fam Physician 54(3):394–402PubMed Lau E, Papaioannou A, Dolovich L, Adachi J, Sawka AM, Burns S, Nair K, Pathak A (2008) Patients’ adherence to osteoporosis therapy: exploring the perceptions of postmenopausal women. Can Fam Physician 54(3):394–402PubMed
111.
112.
go back to reference Conti F, Piscitelli P, Italiano G, Parma A, Caffetti MC, Giolli L, Di Tanna GL, Guazzini A, Brandi ML (2012) Adherence to calcium and vitamin D supplementations: results from the ADVICE survey. Clin Cases Miner Bone Metab 9(3):157–160PubMedPubMedCentral Conti F, Piscitelli P, Italiano G, Parma A, Caffetti MC, Giolli L, Di Tanna GL, Guazzini A, Brandi ML (2012) Adherence to calcium and vitamin D supplementations: results from the ADVICE survey. Clin Cases Miner Bone Metab 9(3):157–160PubMedPubMedCentral
113.
go back to reference Modi A, Sen S, Adachi JD, Adami S, Cortet B, Cooper AL, Geusens P, Mellstrom D, Weaver J, van den Bergh JP, Nguyen AM, Sajjan S (2016) Gastrointestinal symptoms and association with medication use patterns, adherence, treatment satisfaction, quality of life, and resource use in osteoporosis: baseline results of the MUSIC-OS study. Osteoporos Int 27(3):1227–1238. https://doi.org/10.1007/s00198-015-3388-3 CrossRefPubMed Modi A, Sen S, Adachi JD, Adami S, Cortet B, Cooper AL, Geusens P, Mellstrom D, Weaver J, van den Bergh JP, Nguyen AM, Sajjan S (2016) Gastrointestinal symptoms and association with medication use patterns, adherence, treatment satisfaction, quality of life, and resource use in osteoporosis: baseline results of the MUSIC-OS study. Osteoporos Int 27(3):1227–1238. https://​doi.​org/​10.​1007/​s00198-015-3388-3 CrossRefPubMed
116.
go back to reference Turbi C, Herrero-Beaumont G, Acebes JC, Torrijos A, Grana J, Miguelez R, Sacristan J, Marin F (2004) Compliance and satisfaction with raloxifene versus alendronate for the treatment of postmenopausal osteoporosis in clinical practice: an open-label, prospective, nonrandomized, observational study. Clin Ther 26(2):245–256CrossRef Turbi C, Herrero-Beaumont G, Acebes JC, Torrijos A, Grana J, Miguelez R, Sacristan J, Marin F (2004) Compliance and satisfaction with raloxifene versus alendronate for the treatment of postmenopausal osteoporosis in clinical practice: an open-label, prospective, nonrandomized, observational study. Clin Ther 26(2):245–256CrossRef
118.
go back to reference Steel SA, Albertazzi P, Howarth EM, Purdie DW (2003) Factors affecting long-term adherence to hormone replacement therapy after screening for osteoporosis. Climacteric 6(2):96–103CrossRef Steel SA, Albertazzi P, Howarth EM, Purdie DW (2003) Factors affecting long-term adherence to hormone replacement therapy after screening for osteoporosis. Climacteric 6(2):96–103CrossRef
127.
132.
go back to reference DiMatteo MR, Lepper HS, Croghan TW (2000) Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 160(14):2101–2107CrossRef DiMatteo MR, Lepper HS, Croghan TW (2000) Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 160(14):2101–2107CrossRef
135.
go back to reference Bianchi ML, Duca P, Vai S, Guglielmi G, Viti R, Battista C, Scillitani A, Muscarella S, Luisetto G, Camozzi V, Nuti R, Caffarelli C, Gonnelli S, Albanese C, De Tullio V, Isaia G, D'Amelio P, Broggi F, Croci M (2015) Improving adherence to and persistence with oral therapy of osteoporosis. Osteoporos Int 26(5):1629–1638. https://doi.org/10.1007/s00198-015-3038-9 CrossRefPubMed Bianchi ML, Duca P, Vai S, Guglielmi G, Viti R, Battista C, Scillitani A, Muscarella S, Luisetto G, Camozzi V, Nuti R, Caffarelli C, Gonnelli S, Albanese C, De Tullio V, Isaia G, D'Amelio P, Broggi F, Croci M (2015) Improving adherence to and persistence with oral therapy of osteoporosis. Osteoporos Int 26(5):1629–1638. https://​doi.​org/​10.​1007/​s00198-015-3038-9 CrossRefPubMed
136.
go back to reference Hiligsmann M, Salas M, Hughes DA, Manias E, Gwadry-Sridhar FH, Linck P, Cowell W (2013) Interventions to improve osteoporosis medication adherence and persistence: a systematic review and literature appraisal by the ISPOR Medication Adherence & Persistence Special Interest Group. Osteoporos Int 24(12):2907–2918. https://doi.org/10.1007/s00198-013-2364-z CrossRefPubMed Hiligsmann M, Salas M, Hughes DA, Manias E, Gwadry-Sridhar FH, Linck P, Cowell W (2013) Interventions to improve osteoporosis medication adherence and persistence: a systematic review and literature appraisal by the ISPOR Medication Adherence & Persistence Special Interest Group. Osteoporos Int 24(12):2907–2918. https://​doi.​org/​10.​1007/​s00198-013-2364-z CrossRefPubMed
Metadata
Title
A systematic review of factors affecting medication adherence among patients with osteoporosis
Authors
C. T. Yeam
S. Chia
H. C. C. Tan
Y. H. Kwan
W. Fong
J. J. B. Seng
Publication date
01-12-2018
Publisher
Springer London
Published in
Osteoporosis International / Issue 12/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-018-4759-3

Other articles of this Issue 12/2018

Osteoporosis International 12/2018 Go to the issue