Skip to main content
Top
Published in: Osteoporosis International 10/2007

01-10-2007 | Editorial

Adherence to treatment of osteoporosis: a need for study

Authors: F. Lekkerkerker, J. A. Kanis, N. Alsayed, G. Bouvenot, N. Burlet, D. Cahall, A. Chines, P. Delmas, R.-L. Dreiser, D. Ethgen, N. Hughes, J.-M. Kaufman, S. Korte, G. Kreutz, A. Laslop, B. Mitlak, V. Rabenda, R. Rizzoli, A. Santora, R. Schimmer, Y. Tsouderos, P. Viethel, J.-Y. Reginster

Published in: Osteoporosis International | Issue 10/2007

Login to get access

Abstract

Summary

Adherence to anti-osteoporosis medications is currently low and is associated with poor anti-fracture efficacy. This manuscript reviews the potential design of clinical studies that aim to demonstrate improved adherence, with new chemical entities to be used in the management of osteoporosis.

Introduction

Several medications have been unequivocally shown to decrease fracture rates in clinical trials. However, in real life settings, long-term persistence and compliance to anti-osteoporosis medication is poor, hence decreasing the clinical benefits for patients.

Methods

An extensive search of Medline from 1985 to 2006 retrieved all trials including the keywords osteoporosis, compliance, persistence or adherence followed by a critical appraisal of the data obtained through a consensus expert meeting.

Results

The impact of non-adherence on the clinical development of interventions is reviewed, so that clinicians, regulatory agencies and reimbursement agencies might be better informed of the problem, in order to stimulate the necessary research to document adherence.

Conclusion

Adherence to therapy is a major problem in the treatment of osteoporosis. Both patients and medication factors are involved. Adherence studies are an important aspect of outcomes studies, but study methodologies are not well developed at the moment and should be improved. Performing adherence studies will be stimulated when registration authorities accept the result of these studies and include the relevant information in Sect. 5.1 of the summary of product characteristics. Reimbursement authorities might also consider such studies as important information for decisions on reimbursement.
Literature
1.
go back to reference Caro JJ, Ishak KJ, Huybrechts KF et al (2004) The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporosis Int 15:1003–1008CrossRef Caro JJ, Ishak KJ, Huybrechts KF et al (2004) The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporosis Int 15:1003–1008CrossRef
2.
go back to reference Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38:922–928PubMedCrossRef Huybrechts KF, Ishak KJ, Caro JJ (2006) Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone 38:922–928PubMedCrossRef
3.
go back to reference Siris ES, Harris ST, Rosen CJ et al (2006) Adherence to bisphosphonate therapy and fracture rtes in osteoporotic women: relationship to vertebral and non-vertebral fractures from 2 US claims databases. Mayo Clinic Proc 81:1013–1022CrossRef Siris ES, Harris ST, Rosen CJ et al (2006) Adherence to bisphosphonate therapy and fracture rtes in osteoporotic women: relationship to vertebral and non-vertebral fractures from 2 US claims databases. Mayo Clinic Proc 81:1013–1022CrossRef
4.
go back to reference Clowes JA, Peel NFA, Eastell R (2004) The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomised controlled trial. J Clin Endocrinol Metab 89:1117–1123PubMedCrossRef Clowes JA, Peel NFA, Eastell R (2004) The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomised controlled trial. J Clin Endocrinol Metab 89:1117–1123PubMedCrossRef
5.
go back to reference Yood RA, Emani S, Reid JI et al (2003) Compliance with pharmacological therapy for osteoporosis. Osteoporosis Int 14:965–968CrossRef Yood RA, Emani S, Reid JI et al (2003) Compliance with pharmacological therapy for osteoporosis. Osteoporosis Int 14:965–968CrossRef
6.
go back to reference Silverman S, Siris E, Abbott T et al (2003) Adherence to bisphosphonate therapy is associated with decreased non-vertebral osteoporotic fracture risk. J Bone Miner Res 20 (suppl 1):S286 Silverman S, Siris E, Abbott T et al (2003) Adherence to bisphosphonate therapy is associated with decreased non-vertebral osteoporotic fracture risk. J Bone Miner Res 20 (suppl 1):S286
7.
go back to reference Weycker D, Macarios D, Edelsberg J et al (2006) Compliance with drug therapy for postmenopausal osteoporosis. Osteoporosis Int 17:1645–1652CrossRef Weycker D, Macarios D, Edelsberg J et al (2006) Compliance with drug therapy for postmenopausal osteoporosis. Osteoporosis Int 17:1645–1652CrossRef
8.
go back to reference Compston JE, Seeman E (2006) Compliance with osteoporosis therapy is the weakest link. Lancet 368:2005–2006CrossRef Compston JE, Seeman E (2006) Compliance with osteoporosis therapy is the weakest link. Lancet 368:2005–2006CrossRef
9.
go back to reference Miller NH (1997) Compliance with treatment regimens in chronic asymptomatic diseases. Am J Med 102:43–49PubMedCrossRef Miller NH (1997) Compliance with treatment regimens in chronic asymptomatic diseases. Am J Med 102:43–49PubMedCrossRef
10.
go back to reference Willey C, Redding C, Stafford J et al (2000) Stages of change for adherence with medication regimens for chronic diseases: development and validation of a measure. Clin Ther 22:858–871PubMedCrossRef Willey C, Redding C, Stafford J et al (2000) Stages of change for adherence with medication regimens for chronic diseases: development and validation of a measure. Clin Ther 22:858–871PubMedCrossRef
11.
go back to reference Donovan JL (1995) Patient decision making. The missing ingredient in compliance research. Int J Technol Assess Health Care 11:443–455PubMed Donovan JL (1995) Patient decision making. The missing ingredient in compliance research. Int J Technol Assess Health Care 11:443–455PubMed
12.
13.
go back to reference Lutfey KE, Wishner WJ (1999) Beyond “compliance” is “adherence”. Improving the prospect of diabetes care. Diabetes Care 22:635–639PubMedCrossRef Lutfey KE, Wishner WJ (1999) Beyond “compliance” is “adherence”. Improving the prospect of diabetes care. Diabetes Care 22:635–639PubMedCrossRef
14.
15.
go back to reference Madden BP (1990) The hybrid model for concept development: its value for the study of therapeutic alliance. ANS Adv Nurs Sci 12:75–87PubMed Madden BP (1990) The hybrid model for concept development: its value for the study of therapeutic alliance. ANS Adv Nurs Sci 12:75–87PubMed
16.
go back to reference Mullen PD (1997) Compliance becomes concordance. B Med J 314:691–692 Mullen PD (1997) Compliance becomes concordance. B Med J 314:691–692
17.
go back to reference McCombs JS, Thiebaudet P, McLaughlin-Milet C et al (2004) Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas 48:271–287PubMedCrossRef McCombs JS, Thiebaudet P, McLaughlin-Milet C et al (2004) Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas 48:271–287PubMedCrossRef
18.
go back to reference Cooper A, Drake J, Brankin E, on behalf of the persist investigators (2006) Treatment persistence with once-monthly ibandronate and patient support vs. once weekly alendronate: results from the PERSIST study. J Clin Practice 60:896–905CrossRef Cooper A, Drake J, Brankin E, on behalf of the persist investigators (2006) Treatment persistence with once-monthly ibandronate and patient support vs. once weekly alendronate: results from the PERSIST study. J Clin Practice 60:896–905CrossRef
19.
go back to reference Cramer JA, Amonkar MM, Hebborn A et al (2005) Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 21:1453–1460PubMedCrossRef Cramer JA, Amonkar MM, Hebborn A et al (2005) Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin 21:1453–1460PubMedCrossRef
20.
go back to reference Fardellone P, Gaudin AF, Cotte FE (2005) Comparison of the persistence of daily and weekly bisphosphonates in female patients treated for osteoporosis. J Bone Miner Res 20 (Suppl 1):S285–S286 Fardellone P, Gaudin AF, Cotte FE (2005) Comparison of the persistence of daily and weekly bisphosphonates in female patients treated for osteoporosis. J Bone Miner Res 20 (Suppl 1):S285–S286
21.
go back to reference Solomon DH, Avorn J, Katz et al (2005) Compliance with osteoporosis indications. Arch Intern Med 165:2414–2419PubMedCrossRef Solomon DH, Avorn J, Katz et al (2005) Compliance with osteoporosis indications. Arch Intern Med 165:2414–2419PubMedCrossRef
22.
go back to reference Docherty SM, Goodley A, Steel SA (2005) Compliance and effect of bone protective treatment in elderly females: 5 year follow-up study. Rheumatology 44(Suppl 1):134 Docherty SM, Goodley A, Steel SA (2005) Compliance and effect of bone protective treatment in elderly females: 5 year follow-up study. Rheumatology 44(Suppl 1):134
23.
go back to reference Tosteson ANA, Grove MR, Hammond CS et al (2003) Early discontinuation of treatment for osteoporosis. Am J Med 115:209–216PubMedCrossRef Tosteson ANA, Grove MR, Hammond CS et al (2003) Early discontinuation of treatment for osteoporosis. Am J Med 115:209–216PubMedCrossRef
24.
go back to reference Hamilton B, McCoy K, Taggart H (2003) Tolerability and compliance with risedronate in clinical practice. Osteoporosis Int 14:259–262 Hamilton B, McCoy K, Taggart H (2003) Tolerability and compliance with risedronate in clinical practice. Osteoporosis Int 14:259–262
25.
go back to reference Prowse D, McGetrick V, Thompson AJ et al (2005) Persistence with oral therapy is high amongst patients followed in a DGH osteoporosis. Clinical Rheumatology 44(Suppl):135CrossRef Prowse D, McGetrick V, Thompson AJ et al (2005) Persistence with oral therapy is high amongst patients followed in a DGH osteoporosis. Clinical Rheumatology 44(Suppl):135CrossRef
26.
go back to reference Briesacher BA, Andrade S, Kahler K et al (2006) Economic impact of the previous year’s adherence with bisphosphonates. J Bone Miner Res 21(suppl 1):S171 Briesacher BA, Andrade S, Kahler K et al (2006) Economic impact of the previous year’s adherence with bisphosphonates. J Bone Miner Res 21(suppl 1):S171
27.
go back to reference World Health Organization (2003) Adherence to long-term therapies: Evidence for action. WHO, Geneva, Switzerland World Health Organization (2003) Adherence to long-term therapies: Evidence for action. WHO, Geneva, Switzerland
28.
go back to reference Lamberg L (2000) Patient-physician relationship critical even during brief “medication checks”. JAMA 284:29–31PubMedCrossRef Lamberg L (2000) Patient-physician relationship critical even during brief “medication checks”. JAMA 284:29–31PubMedCrossRef
29.
go back to reference Eraker SA, Kirscht JP, Becker MH (1984) Understanding and improving patient compliance. Ann Intern Med 100:258–268PubMed Eraker SA, Kirscht JP, Becker MH (1984) Understanding and improving patient compliance. Ann Intern Med 100:258–268PubMed
30.
go back to reference Ammassari A, Trotta MP, Murri R et al (2002) Study group correlates and predictors of adherence to highly active antiretroviral therapy: Overview of Published. JAIDS 31(suppl 3):S123–S127PubMed Ammassari A, Trotta MP, Murri R et al (2002) Study group correlates and predictors of adherence to highly active antiretroviral therapy: Overview of Published. JAIDS 31(suppl 3):S123–S127PubMed
31.
go back to reference McCloskey E, de Takats D, Orgee J et al (2005) Characteristics associated with non-persistence during daily therapy. Experience from the placebo wing of a community-based clinical trial. J Bone Miner Res 20(suppl 1):S282 McCloskey E, de Takats D, Orgee J et al (2005) Characteristics associated with non-persistence during daily therapy. Experience from the placebo wing of a community-based clinical trial. J Bone Miner Res 20(suppl 1):S282
32.
go back to reference Claxton AJ, Cranmer J, Pierce C (2001) A systematic review of the associations between dose regimens and medication compliance. Clin Ther 23:1296–1310PubMedCrossRef Claxton AJ, Cranmer J, Pierce C (2001) A systematic review of the associations between dose regimens and medication compliance. Clin Ther 23:1296–1310PubMedCrossRef
33.
go back to reference Thompson P, Cooper C, Carr A (2005) Factors influencing adherence to bisphosphonates for osteoporosis. J Bone Miner Res 20 (suppl):S394 Thompson P, Cooper C, Carr A (2005) Factors influencing adherence to bisphosphonates for osteoporosis. J Bone Miner Res 20 (suppl):S394
34.
go back to reference Irvine J, Baker B, Smith J et al (1999) Poor adherence to placebo or amiodarone therapy predicts mortality: results from the CAMIAT study Psychosom Med 61:566–575PubMed Irvine J, Baker B, Smith J et al (1999) Poor adherence to placebo or amiodarone therapy predicts mortality: results from the CAMIAT study Psychosom Med 61:566–575PubMed
35.
go back to reference Granger BB, Swedberg K, Ekman I, for the CHARM investigators (2005) Adherence to candesartan and placebo and outcomes in chronic heart failure in the CHARM programme: double-blind, randomised, controlled clinical trial. Lancet 366:2005–2011PubMedCrossRef Granger BB, Swedberg K, Ekman I, for the CHARM investigators (2005) Adherence to candesartan and placebo and outcomes in chronic heart failure in the CHARM programme: double-blind, randomised, controlled clinical trial. Lancet 366:2005–2011PubMedCrossRef
36.
go back to reference Delmas PD, Vrijens B, Eastell R et al (2007) Improving measurements of persistence on actonel treatment (IMPACT) investigators. Effect of monitoring bone turnover markers on persistence with risedronate treatment of postmenopausal osteoporosis. J Clin Endocrinol Metab 92:296–304CrossRef Delmas PD, Vrijens B, Eastell R et al (2007) Improving measurements of persistence on actonel treatment (IMPACT) investigators. Effect of monitoring bone turnover markers on persistence with risedronate treatment of postmenopausal osteoporosis. J Clin Endocrinol Metab 92:296–304CrossRef
37.
go back to reference Cramer JA, Silverman S (2006) Persistence with Bisphosphonate Treatment for Osteoporosis: Finding the root of the problem. Am J Med 119:S12–S17PubMedCrossRef Cramer JA, Silverman S (2006) Persistence with Bisphosphonate Treatment for Osteoporosis: Finding the root of the problem. Am J Med 119:S12–S17PubMedCrossRef
38.
go back to reference Kanis JA et al (2007) Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 11:1–256 Kanis JA et al (2007) Glucocorticoid-induced osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 11:1–256
40.
go back to reference Spilker B (1991) Methods of assessing and improving patient compliance in clinical trials. In: Cramer JA, Spilker B (eds) (1991) Patient compliance in medical practice and clinical trials. Raven press, New York pp 37–56 Spilker B (1991) Methods of assessing and improving patient compliance in clinical trials. In: Cramer JA, Spilker B (eds) (1991) Patient compliance in medical practice and clinical trials. Raven press, New York pp 37–56
41.
go back to reference Melnikow J, Kiefe C (1994) Patient compliance and medical research. Issues in methodology. J Gen Int Med 9:96–105CrossRef Melnikow J, Kiefe C (1994) Patient compliance and medical research. Issues in methodology. J Gen Int Med 9:96–105CrossRef
42.
go back to reference Turbi C, Herrero-Beaumont G, Acebes JC et al (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 26:245–256PubMedCrossRef Turbi C, Herrero-Beaumont G, Acebes JC et al (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 26:245–256PubMedCrossRef
43.
go back to reference Farmer KC (1999) Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther 21:1074–1090PubMedCrossRef Farmer KC (1999) Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther 21:1074–1090PubMedCrossRef
44.
go back to reference Straka RJ, Fish JT, Benson SR et al (1997) Patient self-reporting of compliance does not correspond with electronic monitoring: an evaluation using isosorbide dinitrate as a model drug. Pharmacotherapy 17:126–132PubMed Straka RJ, Fish JT, Benson SR et al (1997) Patient self-reporting of compliance does not correspond with electronic monitoring: an evaluation using isosorbide dinitrate as a model drug. Pharmacotherapy 17:126–132PubMed
45.
go back to reference Lee JY, Kusek JW, Greene PG et al (1996) Assessing medication adherence by pill count and electronic monitoring in the African American Study of Kidney Disease and Hypertension (AASK) Pilot Study. Am J Hypertens 9:719–725PubMedCrossRef Lee JY, Kusek JW, Greene PG et al (1996) Assessing medication adherence by pill count and electronic monitoring in the African American Study of Kidney Disease and Hypertension (AASK) Pilot Study. Am J Hypertens 9:719–725PubMedCrossRef
46.
go back to reference Mason BJ, Matsuyama JR, Jue SG (1995) Assessment of sulfonylurea adherence and metabolic control. Diabetes Educ 21:52–57PubMedCrossRef Mason BJ, Matsuyama JR, Jue SG (1995) Assessment of sulfonylurea adherence and metabolic control. Diabetes Educ 21:52–57PubMedCrossRef
47.
go back to reference Paes AH, Bakker A, Soe-Agnie CJ (1998) Measurement of patient compliance. Pharm World Sci 20:73–77PubMedCrossRef Paes AH, Bakker A, Soe-Agnie CJ (1998) Measurement of patient compliance. Pharm World Sci 20:73–77PubMedCrossRef
48.
go back to reference Pullar T, Feely M (1990) Problems of compliance with drug treatment: new solutions? Pharm J 245:213–215 Pullar T, Feely M (1990) Problems of compliance with drug treatment: new solutions? Pharm J 245:213–215
49.
go back to reference Schwed A, Fallab CL, Burnier M et al (1999) Electronic monitoring of compliance to lipid-lowering therapy in clinical practice. J Clin Pharmacol 39:402–409PubMedCrossRef Schwed A, Fallab CL, Burnier M et al (1999) Electronic monitoring of compliance to lipid-lowering therapy in clinical practice. J Clin Pharmacol 39:402–409PubMedCrossRef
Metadata
Title
Adherence to treatment of osteoporosis: a need for study
Authors
F. Lekkerkerker
J. A. Kanis
N. Alsayed
G. Bouvenot
N. Burlet
D. Cahall
A. Chines
P. Delmas
R.-L. Dreiser
D. Ethgen
N. Hughes
J.-M. Kaufman
S. Korte
G. Kreutz
A. Laslop
B. Mitlak
V. Rabenda
R. Rizzoli
A. Santora
R. Schimmer
Y. Tsouderos
P. Viethel
J.-Y. Reginster
Publication date
01-10-2007
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 10/2007
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-007-0410-4

Other articles of this Issue 10/2007

Osteoporosis International 10/2007 Go to the issue