title: Influence of patient training on persistence, compliance, and tolerability of different dosing frequency regimens of bisphosphonate therapy: An observational study in Turkish patients with postmenopausal osteoporosis.
abstract: OBJECTIVE
  In our study, we aimed to evaluate the influence of training on compliance and persistence with bisphosphonate treatment given on a weekly vs. monthly basis in postmenopausal osteoporosis patients.
  
  
  METHODS
  A total of 979 patients with postmenopausal osteoporosis (mean age: 63.2 ± 7.2 years) were included in this national, multicenter, prospective non-interventional observational cohort registry study. Patients were randomized into training (n = 492, 50.3%, mean age: 63.4 ± 7.2 years) and control (n = 487, 49.7%, mean age: 63.0 ± 7.1 years) groups. Patients in each intervention group were given weekly (44.9% and 44.6% for training and control subjects, respectively) or monthly (55.1% and 55.4%, respectively) bisphosphonate regimens. After the initial visit, patients were followed up at three-month intervals throughout 12 months of treatment for evaluation of persistence, compliance and adverse events.
  
  
  RESULTS
  On average, 79.4% of the patients were persistent with the treatment with a mean of 350.4 days of duration during the 12-month follow-up period. The mean compliance in the compliant and fully compliant group remained at an average of 86.6%. No significant difference was detected between the training and control groups in terms of compliance and persistence. Significantly longer persistence (360.0 ± 89.0 vs. 345.0 ± 108.0 days; p = 0.035), higher percentage of persistent patients (83.4% vs. 74.2%; p = 0.012) and higher compliance rates (88.8% vs. 83.3%; p = 0.002) were noted in monthly regimen patients in comparison to those given weekly regimen.
  
  
  CONCLUSIONS
  Our findings revealed remarkably high rates for persistence and compliance with bisphosphonate treatment in postmenopausal osteoporosis, with no impact of training on compliance and persistence rates. Longer persistence and better compliance rates were achieved with the monthly bisphosphonate regimen when compared to the weekly regimen.
authors.affiliation: İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey. Electronic address: akarmak@istanbul.edu.tr.
authors.forename: Ülkü
authors.initials: Ü
authors.lastname: Akarırmak
authors.affiliation: İzmir Atatürk Training and Research Hospital, İzmir, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Koçyiğit
authors.affiliation: İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
authors.forename: Nurten
authors.initials: N
authors.lastname: Eskiyurt
authors.affiliation: İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
authors.forename: Sina
authors.initials: S
authors.lastname: Esmaeilzadeh
authors.affiliation: Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey.
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Kuru
authors.affiliation: İstanbul Physical Therapy and Rehabilitation Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ebru Yılmaz
authors.initials: EY
authors.lastname: Yalçinkaya
authors.affiliation: Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey.
authors.forename: Özlen
authors.initials: Ö
authors.lastname: Peker
authors.affiliation: Eskişehir Training and Research Hospital, Eskişehir, Turkey.
authors.forename: Ayşe Aydemir
authors.initials: AA
authors.lastname: Ekim
authors.affiliation: Ankara Physical Therapy and Rehabilitation Hospital, Ankara, Turkey.
authors.forename: Neşe
authors.initials: N
authors.lastname: Özgirgin
authors.affiliation: Erciyes University, School of Medicine, Kayseri, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Çalış
authors.affiliation: Bezm-i Alem University, Faculty of Medicine, İstanbul, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Rezvani
authors.affiliation: Dışkapı Yıldırım Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Alev
authors.initials: A
authors.lastname: Çevikol
authors.affiliation: Ege University, Faculty of Medicine, İzmir, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Eyigör
authors.affiliation: Adnan Menderes University, School of Medicine, Aydın, Turkey.
authors.forename: Ömer Faruk
authors.initials: ÖF
authors.lastname: Şendur
authors.affiliation: Uludağ University, School of Medicine, Bursa, Turkey.
authors.forename: Jale
authors.initials: J
authors.lastname: İrdesel
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D004164:Diphosphonates / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D010353:Patient Education as Topic / Q000379:methods; D011446:Prospective Studies; D014421:Turkey; D016903:Drug Monitoring
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Bisphosphonate; Compliance; Dosing regimen; Osteoporosis; Persistence; Training