title: Patient-reported barriers to osteoporosis therapy.
abstract: We investigated reasons for non-treatment of osteoporosis and discontinuation of osteoporosis therapy. Barriers to treatment include patients' preference for alternative treatments and a fear of possible side effects. Side effects are a common reason for treatment discontinuation, and they may be associated with a lack of willingness to restart treatment.
  
  
  OBJECTIVE
  Osteoporosis patients commonly cite treatment-related side effects, or the fear thereof, as a reason for discontinuing or not initiating anti-osteoporosis medications. The purpose of this study was to investigate, from the patient's perspective, reasons for (i) non-treatment of osteoporosis and (ii) discontinuation of osteoporosis therapy.
  
  
  METHODS
  This was an internet-based survey of postmenopausal women in the USA who self-reported having been diagnosed with osteoporosis. Respondents were recruited from consumer research panels and received nominal compensation.
  
  
  RESULTS
  Within the surveyed population (N = 1407), 581 patients were currently being treated, 503 had never been treated, and 323 had previously been treated. Among patients never treated for osteoporosis, the highest ranking reasons for non-treatment were the use of alternative treatments such as over-the-counter vitamins/supplements (57.5 % of respondents) and fear of side effects (43.9 %). Among previously treated patients, frequent reasons for discontinuation included the direction of the physician (41.2 % of respondents), concerns about long-term safety (30.3 %), and the experience of side effects (29.8 %). When asked about their willingness to restart their osteoporosis medication, previously treated patients who were not willing (N = 104) to restart had a higher frequency of experiencing side effects (44.2 versus 20.5 % of those willing; P < 0.001).
  
  
  CONCLUSIONS
  From the osteoporosis patient's perspective, barriers to prescription treatment include a preference for alternative, non-prescription treatments and a fear of possible side effects. Side effects are one of the most common reasons for discontinuing osteoporosis medications, and they appear to be associated with a lack of willingness to restart treatment.
authors.affiliation: Center for Observational and Real-World Evidence, Merck & Co. Inc., Kenilworth, NJ, USA. Brianna_lindsay@merck.com.
authors.forename: Brianna R
authors.initials: BR
authors.lastname: Lindsay
authors.affiliation: Center for Observational and Real-World Evidence, Merck & Co. Inc., Kenilworth, NJ, USA.
authors.forename: Temitope
authors.initials: T
authors.lastname: Olufade
authors.affiliation: Nielsen, New York, NY, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Bauer
authors.affiliation: Nielsen, New York, NY, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Babrowicz
authors.affiliation: Nielsen, New York, NY, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hahn
mesh_terms: D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D017698:Postmenopause / Q000523:psychology*; D057566:Self Report; D014481:United States
chemical_list: D050071:Bone Density Conservation Agents
keywords: Health knowledge, attitudes, practice; Health surveys; Medication adherence; Osteoporosis, postmenopausal/drug therapy; Patient compliance; Persistence