title: Assessment and potential determinants of compliance and persistence to antiosteoporosis therapy in Italy.
abstract: To analyze adherence to antiosteoporosis drugs (AODs) and to assess the influence of patient-related and drug-related factors.
  
  
  
  Observational, retrospective study.
  
  
  
  Data on prescriptions for AODs from 2007 through 2008 were retrieved from administrative databases of 10 Italian local health units. Key measurements included compliance and persistence at 1 year. Multivariate regression analyses were performed to estimate adjusted risk ratios for compliance less than 80% and adjusted hazard ratios for no persistence.
  
  
  
  Of 40,004 new patients (89.9% women, mean age 69.8 years), 84.0% were treated with bisphosphonates and 74.6% of administration regimens were weekly. Overall, 75.1% of patients had suboptimal levels of compliance and 84.7% were not persistent; almost one-third had only 1 prescription. In regression analyses, younger age, change of drug, and concomitant corticosteroid therapy were significantly associated to compliance and persistence in both genders. In women, weekly and monthly regimens reduced the risk for poor compliance (sex-adjusted relative risks 0.729 [0.697-0.762], 0.846 [0.817-0.876], respectively) and no persistence (sex-adjusted hazard ratios 0.591 [0.541-0.646], 0.508 [0.461-0.560], respectively) compared with a daily regimen.
  
  
  
  In our study, 75% of subjects had discontinuous treatment and inadequate drug supply. Age and frequency of administration were strongly associated with adherence. Improvement is urgently needed, and occasional prescriptions represent the main target.
authors.forename: Manuela
authors.initials: M
authors.lastname: Casula
authors.forename: Alberico Luigi
authors.initials: AL
authors.lastname: Catapano
authors.forename: Rossana
authors.initials: R
authors.lastname: Piccinelli
authors.forename: Enrica
authors.initials: E
authors.lastname: Menditto
authors.forename: Lamberto
authors.initials: L
authors.lastname: Manzoli
authors.forename: Luisa
authors.initials: L
authors.lastname: De Fendi
authors.forename: Valentina
authors.initials: V
authors.lastname: Orlando
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Flacco
authors.forename: Marco
authors.initials: M
authors.lastname: Gambera
authors.forename: Alessandro
authors.initials: A
authors.lastname: Filippi
authors.forename: Elena
authors.initials: E
authors.lastname: Tragni
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000367:Age Factors; D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy*; D012307:Risk Factors; D012737:Sex Factors; D016903:Drug Monitoring
chemical_list: D000305:Adrenal Cortex Hormones; D050071:Bone Density Conservation Agents; D004164:Diphosphonates