title: Non-adherence with bisphosphonates among patients with osteoporosis: impact on fracture risk and healthcare cost‏.
abstract: Osteoporosis-related fractures at the spine and hip have a substantial impact on mortality, morbidity, and quality of life in older adults worldwide. Adherence to bisphosphonates is essential for effective treatment and fracture prevention. Nevertheless, numerous studies from various populations and study designs clearly indicated that adherence and persistence are poor with more than 50% of patients discontinuing therapy within one year. This is primarily explained by mild adverse effects, dosing regimens, and costs. Studies have also shown that good adherence is associated with reduced osteoporosis-related and non-related healthcare costs as soon as 2 years from therapy initiation. Nonetheless, we found only little improvement in adherence rates over the years. In light of the importance of medication adherence and the limited success of previous programs, other than reducing dosing frequency, new directions should be explored to engage patients and care givers in order to improve adherence and prevent fractures.
authors.affiliation: a Medical division , Maccabi Healthcare Services , Tel Aviv , Israel.|b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
authors.affiliation: a Medical division , Maccabi Healthcare Services , Tel Aviv , Israel.
authors.forename: Sarah Sharman
authors.initials: SS
authors.lastname: Moser
authors.affiliation: a Medical division , Maccabi Healthcare Services , Tel Aviv , Israel.|b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors.forename: Inbal
authors.initials: I
authors.lastname: Goldshtein
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D055118:Medication Adherence; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D058866:Osteoporotic Fractures / Q000191:economics / Q000209:etiology / Q000517:prevention & control; D011788:Quality of Life; D013997:Time Factors
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Osteoporosis; adherence; fracture; healthcare costs; persistence