Adherence and persistence: impact on outcomes and health care resources.
Non-adherence to and poor persistence with antiresorptive medication are significant problems in preventing adverse consequences of osteoporosis. Adherence rates for oral bisphosphonate therapy drop off dramatically during the first year of treatment and continue to decline thereafter. Inadequate adherence is associated with smaller decreases in rate of bone turnover, smaller bone mineral density (BMD) gains, and greater risk of fracture. Measures to improve patient adherence include improved physician/patient communication, close monitoring, and early intervention in declining adherence. Another approach is strengthening of patient commitment through reinforcement of the connection between treatment response and quality of life benefits. Use of biochemical markers of response or BMD measurements to illustrate response to patients may be useful in this regard. Simplification of treatment regimens would also be of considerable value in improving adherence and persistence.
Reginster
Jean-Yves
JY
World Health Organisation Collaborating Center for Public Health Aspects of Rheumatic Diseases, University of Liège, 4020 Liège, Belgium. jyreginster@ulg.ac.be
D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care; D004164:Diphosphonates / Q000627:therapeutic use; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy*; D010349:Patient Compliance; D016016:Proportional Hazards Models; D016896:Treatment Outcome
D015415:Biomarkers; D050071:Bone Density Conservation Agents; D004164:Diphosphonates