title: Compliance to antifracture treatments in Tuscany: a regional survey based on institutional pharmaceutical dataset.
abstract: OBJECTIVE
  compliance to any antifracture therapy is the most important parameter affecting the effectiveness of the treatment. The aim of this study was to evaluate patients compliance to antifracture therapies in the whole Tuscany population who benefit from treatments reimbursed by the Regional Healthcare System.
  
  
  METHODS
  we have analyzed all antifracture drug prescriptions recorded in Tuscany regional pharmaceutical database concerning year 2009, from both in-hospital distribution database (direct drug delivery, FED), and private pharmacies across the whole region (SPF). Patients who started the treatment in 2008 and those continuing it in 2010 were also considered in the analysis. The sample size consisted in 92,250 people (1:9 male to female ratio). Compliance to antifracture treatments at 3, 6, 9, and 12 months was analyzed by single drug (using the defined daily dose, DDD), and by age group (40-50, 50-60, 60-70, 70-80, 90-100 years).
  
  
  RESULTS
  patients compliance decreased under 80% after the first 3 months of treatment, reaching no more than 50% at 1 year. Our results show that compliance to antifracture treatments reflects the age of the patients. People aged 70-80 years old represent the age group most frequently treated with antifracture therapies (36.57% of total prescriptions), with alendronic acid being the most prescribed drug (29.73% of total drug prescribed). Monthly dosing did not increase compliance if compared to oral weekly regimens, while daily oral or s.c. dosing were associated to lower compliance rates.
  
  
  CONCLUSIONS
  serious efforts need to be implemented to foster patients motivation in assuming their antifracture treatments for at least one year.
authors.affiliation: Department of Internal Medicine, University of Florence, Florence, Italy.
authors.forename: Prisco
authors.initials: P
authors.lastname: Piscitelli
authors.forename: Gemma
authors.initials: G
authors.lastname: Marcucci
authors.forename: Simone
authors.initials: S
authors.lastname: Parri
authors.forename: Loredana
authors.initials: L
authors.lastname: Cavalli
authors.forename: Emanuela
authors.initials: E
authors.lastname: Colli
authors.forename: Luciana
authors.initials: L
authors.lastname: Pazzagli
authors.forename: Paolo
authors.initials: P
authors.lastname: Batacchi
authors.forename: Teresa
authors.initials: T
authors.lastname: Brocca
authors.forename: Valtere
authors.initials: V
authors.lastname: Giovannini
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Brandi