title: First Indian prospective randomized comparative study evaluating adherence and compliance of postmenopausal osteoporotic patients for daily alendronate, weekly risedronate and monthly ibandronate regimens of bisphosphonates.
abstract: OBJECTIVE
  The aim of the following study is to evaluate adherence and compliance of postmenopausal osteoporotic patients for different regimens of bisphosphonates (BP).
  
  
  METHODS
  A prospective observational randomized comparative 1 year study was undertaken to evaluate the adherence/compliance rates of most commonly prescribed daily alendronate (ALN), weekly risedronate (RIS) and monthly ibandronate (IBN) BP regimens.
  
  
  RESULTS
  Nearly 40% was the 1 year adherence rate with BP and 41.33% of non-compliance. Whereas, 8.66% was interrupted compliance rate and 6% switched over to other anti-osteoporotic treatment. The three treatment arm did not vary significantly. However, numerically maximum adherence rate of 56% was recorded in monthly BP regimen followed by weekly (36%) and daily regimen (32%). Medication possession rate confirmed on a follow-up visit was maximum with monthly regimen as 84.61% followed by daily (62.5%) and weekly (61.11%) respectively. Average time in days for non-adherence was 48, 56 and 92 day with daily ALN, weekly RIS and monthly IBN regimen respectively. Age, mean age at menopause, demographical profile failed to influence the adherence. Concomitant treatment for co-morbid condition (57.14%), unawareness about osteoporosis (OP) (50%), cost of treatment (45.33%), belief that drugs is for their general disability (39.28%), physician's failure to stress the need and necessary calcium + vitamin D daily requirement (23.80%) each were the most prevalent factors responsible for non-adherence. Intolerance and adverse drug reactions were responsible for only 13.09% and 11.90% of non-adherence.
  
  
  CONCLUSIONS
  Treatment compliance is poor with daily ALN, weekly RIS and monthly IBN regimen along with calcium and vitamin D3 in Indian paramedical workers suffering OP.
authors.affiliation: Department of Pharmacology and Therapeutics, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Vishal R
authors.initials: VR
authors.lastname: Tandon
authors.affiliation: Department of Obstetrics and Gynaecology, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Sudhaa
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Nephrology-Super-Specialty Hospital, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Shagun
authors.initials: S
authors.lastname: Mahajan
authors.affiliation: Department of Internal Medicine, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Annil
authors.initials: A
authors.lastname: Mahajan
authors.affiliation: Department of Pharmacology and Therapeutics, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Khajuria
authors.affiliation: Department of Pharmacology and Therapeutics, Government Medical College, Jammu, Jammu and Kashmir, India.
authors.forename: Zahid
authors.initials: Z
authors.lastname: Gillani
keywords: Adherence; alendronate; bisphosphonates; compliance; ibandronate; postmenopausal osteoporosis; risedronate