title: Alendronate 70 therapy in elderly women with post-menopausal osteoporosis: the problem of compliance.
abstract: BACKGROUND
  More than half of those with chronic diseases, including osteoporosis, discontinue treatment during the first year of its administration. This problem increases over the course of continued follow-up. Additionally, it has been observed that 13% of women, prescribed oral daily alendronate, do not even start the treatment, while 20% of patients discontinue the therapy during the first four months. On the other hand, those patients who are compliant achieve increased bone mass density with a simultaneous decrease of fracture risk. The aim of our study was to assess the adherence to the recommended alendronate 70 administration protocol over the course of 12 months by women with post-menopausal osteoporosis.
  
  
  METHODS
  Adherence (compliance plus persistence) to alendronate 70 therapy was assessed in a prospective study of 153 post-menopausal women, followed up for one year with monitoring every two months.
  
  
  RESULTS
  Adherence to therapy of all the study participants was high during the entire study period, the patients remaining compliant after a year in 95.08 ± 1.39% (mean ± SEM) of cases, and the mean persistence with medication was 347.05 ± 5.07 days. In the group of patients who interrupted treatment, the mean persistence was 212.44 days. One of the study participants did not start the treatment, and another two discontinued the therapy within 30-60 days of the study onset (between the first two visits). Facilitated contacts with the doctor, continuous access to prescribed treatment and frequent visits significantly improved patient compliance. The common reason for discontinuation was side effects, while age (but not education) affected the rate of compliance with therapy. The worst results were obtained in the group of patients with osteoporosis diagnosed more than five years before the study, particularly in the subgroup where alendronate was being used for the first time or where treatment resumed after a substantial break.
  
  
  CONCLUSIONS
  The obtained results indicate that better adherence to alendronate 70 therapy, administered once a week, depends on more frequent monitoring of treated patients.
authors.affiliation: Department of Endocrine Disoders and Bone Metabolism, 1st Chair of Endocrinology, Medical University, Łódz, Poland. ewa.sewerynek@wp.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Sewerynek
authors.forename: Bogdan
authors.initials: B
authors.lastname: Małkowski
authors.forename: Ewa
authors.initials: E
authors.lastname: Karzewnik
authors.forename: Wioletta
authors.initials: W
authors.lastname: Stepien-Klos
authors.forename: Maria
authors.initials: M
authors.lastname: Tabaszewska
authors.forename: Marek
authors.initials: M
authors.lastname: Lasota
authors.forename: Grażyna
authors.initials: G
authors.lastname: Krupińska
authors.forename: Anna
authors.initials: A
authors.lastname: Glądalska
authors.forename: Wanda
authors.initials: W
authors.lastname: Horst-Sikorska
authors.forename: Michał
authors.initials: M
authors.lastname: Stuss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011044:Poland; D011446:Prospective Studies
chemical_list: D019386:Alendronate