title: Gender- and age-related treatment compliance in patients with osteoporosis in Germany.
abstract: OBJECTIVE
  The purpose of this study was to analyze treatment compliance in osteoporotic patients treated with osteoporosis medications in Germany.
  
  
  METHODS
  Patients included in the analysis had been diagnosed with osteoporosis with or without fractures and started anti-osteoporotic therapy (bisphosphonates, denosumab, or strontium ranelate) between 2011 and 2014 in a general (GP) or orthopedic practice (OP) setting in Germany. Data pertaining to 6,221 individuals followed in GP and 4,044 individuals followed in OP were analyzed retrospectively. The last follow-up was in December 2015. The main outcome measure was the compliance within the one-year period after the index prescription date. Compliance was measured indirectly and was based on the mean possession ratio (MPR). A multivariate logistic regression model was used to determine the association between MPR (dependent variable) and age, gender, type of practice, type of osteoporosis treatment, therapy frequency, and history of fracture (covariates).
  
  
  RESULTS
  The mean age of the study group was 73.3 years, and 13.2% of subjects were men. Regarding type of practice, 60.6% of individuals were followed in GP and 39.4% in OP. Noncompliance was observed in 55.2% of the patients. Patients in the age group ≤60 years were at a higher risk of being noncompliant when compared to those in the age group of 61-70 years. Men and patients who received oral drugs were also more likely to be noncompliant than women and patients who received injectable or intravenous drugs. Finally, therapies that were given every three or six months were associated with a decrease in the risk of noncompliance when compared to weekly therapy, whereas daily and monthly treatments were associated with an increased risk.
  
  
  CONCLUSIONS
  Compliance is insufficient in osteoporotic patients treated with osteoporosis medications.
authors.affiliation: Department of Bone Oncology, Endocrinology and Reproductive Medicine, Nordwest Hospital, Frankfurt, Germany.
authors.forename: Peyman
authors.initials: P
authors.lastname: Hadji
authors.affiliation: Faculty of Medicine, University of Paris, Paris, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Jacob
authors.affiliation: Epidemiology, IMS Health GmbH & Co. Ohg, Darmstädter Landstraße, Frankfurt, Germany.
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
keywords: Germany; compliance; fracture; osteoporosis treatment; real-world data