title: Proactive pharmaceutical care interventions decrease patients' nonadherence to osteoporosis medication.
abstract: Using a protocolled intervention program, pharmacists can decrease nonadherence to osteoporosis medication, by continuous monitoring and tailored counseling sessions, starting at treatment initiation. In the usual care group, 32.8% of patients initiating osteoporosis medication discontinued or were nonadherent, compared to 19.0% of patients in the intervention group.
  
  
  OBJECTIVE
  While community pharmacies have been shown to offer a promising platform for osteoporosis management in patients with osteoporosis, more research is needed to determine pharmacists' effects on improving adherence. The aim of this study was to determine the effects of a community pharmacists' intervention program on the 1-year discontinuation and nonadherence rates of patients initiating osteoporosis medication.
  
  
  METHODS
  This intervention study included 937 patients, recruited from 13 Dutch community pharmacies, initiating osteoporosis medication. The intervention group (N = 495), received the Medication Monitoring and Optimization (MeMO) intervention, comprising of continuous monitoring of patients' adherence to their osteoporosis medication and tailored counseling sessions with nonadherent patients. Results were compared to an internal (n = 442) reference group, receiving usual pharmacy care. Primary study outcomes were therapy discontinuation and nonadherence; results were adjusted for potential confounders using Cox proportional hazard analysis. Secondary outcome was patients' satisfaction.
  
  
  RESULTS
  In the usual care group, 32.8% of patients initiating osteoporosis medication discontinued or were nonadherent, compared to 19.0% of patients in the intervention group (P < 0.001). Ninety-three percent of the respondents were satisfied with the pharmacies' services provided. Notably, 31% mentioned that the pharmacy was the only place where they received information on various aspects of administration and acting of their medication.
  
  
  CONCLUSIONS
  Pharmacists can decrease nonadherence and discontinuation with osteoporosis medication by providing tailored counseling sessions and continuous monitoring of drug use. Pharmaceutical care programs, such as MeMO, contribute to more optimal use of osteoporosis medication.
authors.affiliation: West Pharmacy, Europalaan 124, 8303 GL, Emmeloord, The Netherlands, ada@fstuurman.nl.
authors.forename: A G G
authors.initials: AG
authors.lastname: Stuurman-Bieze
authors.forename: E G
authors.initials: EG
authors.lastname: Hiddink
authors.forename: J F M
authors.initials: JF
authors.lastname: van Boven
authors.forename: S
authors.initials: S
authors.lastname: Vegter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003376:Counseling / Q000458:organization & administration; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D065386:Historically Controlled Study / Q000379:methods; D006801:Humans; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D009426:Netherlands; D010024:Osteoporosis / Q000188:drug therapy*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010595:Pharmacists / Q000523:psychology; D015397:Program Evaluation
chemical_list: D050071:Bone Density Conservation Agents