title: Compliance, Persistence, and Preferences Regarding Osteoporosis Treatment During Active Therapy or Drug Holiday.
abstract: Osteoporosis treatments reduce the risk of fractures by 30%-50%, but adherence after 1 year is only about 50%. Drug holiday, a period with no active treatment, is part of routine management. The objective of this study was to determine compliance and persistence with osteoporosis therapy among postmenopausal women and to assess attitudes regarding treatment resumption among patients on drug holiday. This was a prospective observational study of patients followed at a dedicated metabolic bone clinic September 2013-February 2014. Compliance was assessed by medication possession ratio (MPR; number of doses dispensed relative to the number prescribed). Persistence was defined as continuation of treatment without a >30-day gap in prescription refills. Of 150 patients (70.1 ± 8.1 years), 57% were prescribed a medication: 64% oral, mostly bisphosphonates. MPR ≥ 80% was found in 80% and <50% in 12%; it was 100% for zoledronic acid and denosumab and 97%, 85%, 83%, and 70% for raloxifene, teriparatide, oral bisphosphonates, and strontium ranelate, respectively. Of 39 patients prescribed oral bisphosphonates, 77% persisted with treatment, and 89% took them as directed. Of 64 patients on a drug holiday, 59% expressed confidence in their physician's future treatment choice, whereas 19% expressed concerns about resuming treatment. Compliance among patients attending a dedicated bone clinic was higher than that reported in the literature. High persistence and compliance may be specific to patients followed in this type of setting. This study provides new information about attitudes of patients on a drug holiday. Most were not concerned about resuming treatment and did not have a preferred medication.
authors.affiliation: Division of Clinical Pharmacy, Pharmacy Services, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Alona
authors.initials: A
authors.lastname: Eliasaf
authors.affiliation: Division of Clinical Pharmacy, Pharmacy Services, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Alina
authors.initials: A
authors.lastname: Amitai
authors.affiliation: Hospital Administration Department, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Mira
authors.initials: M
authors.lastname: Maram Edry
authors.affiliation: Division of Clinical Pharmacy, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel.
authors.forename: Shimona
authors.initials: S
authors.lastname: Yosselson Superstine
authors.affiliation: Bone Health Service, Endocrine Department, Meir Medical Center, Kfar Saba, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. pnina.rotman@clalit.org.il.
authors.forename: Pnina
authors.initials: P
authors.lastname: Rotman Pikielny
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D057240:Patient Preference / Q000523:psychology; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents
keywords: compliance; drug holiday; osteoporosis treatment; persistence; preferences