title: Bisphosphonates adherence for treatment of osteoporosis.
abstract: BACKGROUND
  Osteoporosis is a disease of bone metabolism in which bisphosphonates (BPS) are the most common medications used in its treatment, whose main objective is to reduce the risk of fractures. The aim of this study was to conduct a systematic review on BPs adherence for treatment of osteoporosis.
  
  
  METHODS
  Systematic review of articles on BPs adherence for treatment of osteoporosis, indexed on MEDLINE (via PubMed) databases, from inception of databases until January 2013. Search terms were "Adherence, Medication" (MeSH term), "Bisphosphonates" (MeSH term), and "Osteoporosis" (MeSH term).
  
  
  RESULTS
  Of the 78 identified studies, 27 met the eligibility criteria. Identified studies covered a wide range of aspects regarding adherence and associated factors, adherence and fracture, adherence and BPs dosage. The studies are mostly observational, conducted with women over 45 years old, showing low rates of adherence to treatment. Several factors may influence adherence: socio-economic and cultural, participation of physicians when guidance is given to the patient, the use of bone turnover markers, and use of generic drugs. The monthly dosage is associated with greater adherence compared to weekly dosage.
  
  
  CONCLUSIONS
  Considering the methodological differences between the studies, the results converge to show that adherence to treatment of osteoporosis with BPs is still inadequate. Further experimental studies are needed to evaluate the adherence and suggest new treatment options.
authors.affiliation: Laboratory of Studies Design and Scientific Writing, Faculty of Medicine ABC, Av, Príncipe de Gales, 821, Santo André, SP, 09060-650, Brazil. adamifernando@uol.com.br.
authors.forename: Helena Parente
authors.initials: HP
authors.lastname: Vieira
authors.forename: Ingrid Almeida
authors.initials: IA
authors.lastname: Leite
authors.forename: Thayga Maria
authors.initials: TM
authors.lastname: Araújo Sampaio
authors.forename: Juliane
authors.initials: J
authors.lastname: Dos Anjos de Paula
authors.forename: Ankilma
authors.initials: A
authors.lastname: do Nascimento Andrade
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: de Abreu
authors.forename: Vitor E
authors.initials: VE
authors.lastname: Valenti
authors.forename: Flavia C
authors.initials: FC
authors.lastname: Goulart
authors.forename: Fernando
authors.initials: F
authors.lastname: Adami