title: Oral bisphosphonate compliance and persistence: a matter of choice?
abstract: Compliance to oral bisphosphonates is suboptimal, with negative consequences of increased healthcare utilization and less effective fracture risk reduction. Extending dose interval increased adherence only moderately. We used literature derived from multiple chronic conditions to examine the problem of noncompliance with osteoporosis medication. We reviewed the literature on adherence to osteoporosis medication as well as that across multiple chronic conditions to understand what is known about the cause of the poor adherence. Poor compliance to oral medications is due mostly, not to forgetfulness, but to deliberate choice. Gender differences and style of healthcare management also play a role. Preliminary data suggest psychobehavioral interventions may help to improve motivation. We need to understand better reasons for poor compliance before effective interventions can be developed. Forgetfulness is only a small part of poor compliance. Patient preferences must be considered in medication decision making.
authors.affiliation: Cedars-Sinai/UCLA/OMC, 8641 Wilshire Blvd., Suite 301, Beverly Hills, CA 90211, USA. stuarts@omcresearch.org
authors.forename: S L
authors.initials: SL
authors.lastname: Silverman
authors.forename: J T
authors.initials: JT
authors.lastname: Schousboe
authors.forename: D T
authors.initials: DT
authors.lastname: Gold
mesh_terms: D001294:Attitude to Health; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004164:Diphosphonates / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006801:Humans; D055118:Medication Adherence / Q000523:psychology*; D010024:Osteoporosis / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000517:prevention & control
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
references.citation: Diabetes Care. 2005 Feb;28(2):278-82
references.pmid: 15677779
references.citation: J Bone Miner Res. 2008 Sep;23(9):1435-41
references.pmid: 18442318
references.citation: BMJ. 2008 May 17;336(7653):1114-7
references.pmid: 18480115
references.citation: Osteoporos Int. 2003 Dec;14(12):965-8
references.pmid: 14504697
references.citation: Cochrane Database Syst Rev. 2008 Apr 16;(2):CD000011
references.pmid: 18425859
references.citation: Osteoporos Int. 2007 Mar;18(3):271-7
references.pmid: 17021945
references.citation: Osteoporos Int. 2006;17(3):478-83
references.pmid: 16283066
references.citation: Curr Med Res Opin. 2006 Dec;22(12):2383-91
references.pmid: 17257452
references.citation: Curr Med Res Opin. 2007 Dec;23(12):3137-52
references.pmid: 17988435
references.citation: Osteoporos Int. 2006;17(11):1626-9
references.pmid: 16823543
references.citation: Health Serv Res. 2009 Oct;44(5 Pt 1):1640-61
references.pmid: 19500161
references.citation: Curr Opin Rheumatol. 2009 Jul;21(4):356-62
references.pmid: 19412103
references.citation: Int J Clin Pract. 2006 Aug;60(8):896-905
references.pmid: 16800837
references.citation: J Am Pharm Assoc (2003). 2008 Jan-Feb;48(1):58-63
references.pmid: 18192132
references.citation: Bone. 2009 Jan;44(1):153-9
references.pmid: 18926939
references.citation: Osteoporos Int. 2010 Jan;21(1):145-55
references.pmid: 19459025
references.citation: Osteoporos Int. 2009 Dec;20(12):2127-34
references.pmid: 19499273
references.citation: Telemed J E Health. 2009 Oct;15(8):770-6
references.pmid: 19780692
references.citation: Mayo Clin Proc. 2006 Aug;81(8):1013-22
references.pmid: 16901023
references.citation: Osteoporos Int. 2003 Jul;14(6):490-5
references.pmid: 12730761
references.citation: Med Decis Making. 2009 Jan-Feb;29(1):125-39
references.pmid: 18566486
references.citation: J Rheumatol. 2005 Jun;32(6):1086-92
references.pmid: 15940773
references.citation: Osteoporos Int. 2008 Jun;19(6):811-8
references.pmid: 17999022
references.citation: J Bone Miner Metab. 2010 Mar;28(2):176-84
references.pmid: 19657590
references.citation: Osteoporos Int. 2007 Aug;18(8):1023-31
references.pmid: 17308956
references.citation: JAMA. 2002 Jul 24-31;288(4):462-7
references.pmid: 12132976
references.citation: Maturitas. 2004 Jul 15;48(3):271-87
references.pmid: 15207894
references.citation: Int J Med Inform. 2009 Apr;78(4):230-8
references.pmid: 18778967
references.citation: J Clin Endocrinol Metab. 2007 Apr;92(4):1296-304
references.pmid: 17244788
references.citation: Bone. 2006 Jun;38(6):922-8
references.pmid: 16330270
references.citation: J Nerv Ment Dis. 1999 Oct;187(10):630-5
references.pmid: 10535657
references.citation: Maturitas. 2005 Mar 14;50(3):196-208
references.pmid: 15734601
references.citation: Int J Technol Assess Health Care. 1995 Summer;11(3):443-55
references.pmid: 7591546
references.citation: J Clin Endocrinol Metab. 2004 Mar;89(3):1117-23
references.pmid: 15001596
references.citation: J Clin Hypertens (Greenwich). 2008 May;10(5):348-54
references.pmid: 18453793
references.citation: Osteoporos Int. 2004 Dec;15(12):1003-8
references.pmid: 15167989
references.citation: Bone. 2006 Feb;38(2 Suppl 2):S18-21
references.pmid: 16443406
references.citation: Osteoporos Int. 2008 Jul;19(7):1029-37
references.pmid: 18193329
references.citation: Med Care. 2009 Mar;47(3):334-41
references.pmid: 19194337
references.citation: Curr Rheumatol Rep. 2008 Apr;10(2):118-22
references.pmid: 18460266