Association of medication attitudes with non-persistence and non-compliance with medication to prevent fractures

Abstract

Non-persistence and non-compliance with oral bisphosphonate medication have different, albeit overlapping, sets of predictors. Low perceived necessity of fracture-prevention medication, high concerns about long-term safety of and dependence upon medication , and low medication-use self-efficacy all predict non-persistence with oral bisphosphonates, whereas low medication-use self-efficacy strongly predicts non-compliance with oral bisphosphonate medication. Assessment of and influence of these medication attitudes among patients at high risk of fracture are likely necessary to achieve better persistence and compliance with fracture-prevention therapies.

Percepción de los profesionales médicos respecto la adherencia terapéutica de los pacientes con osteoporosis

“…According to respondents, and in line with other publications, other reasons for this lack of patient adherence are the medication's side effects and polypharmacy; which are also perceived as the most common reasons for a change in treatment with bisphosphonates 26,[28][29][30][31][32] .…”

GRAND: the German retrospective cohort analysis on compliance and persistence and the associated risk of fractures in osteoporotic women treated with oral bisphosphonates

“…One possible explanation may be the gastrointestinal side effects and difficulties with intake of oral bisphosphonates, but there is still a need for greater understanding of the influences on individual habits for non-compliance or nonpersistence and their impact on clinical and economic outcomes [6,27,30,32,33,[35][36][37][38]. The findings in the present analysis are in line with several previous publications indicating that chronic conditions in general are associated with difficulties regarding medication compliance and persistence, including treatments for osteoporosis with vitamin D and calcium [28,31,[39][40][41].…”

Partial adherence: a new perspective on health economic assessment in osteoporosis

“…For example, in a study comparing alendronate and ibandronate, persistence was judged to be 39% and 57%, respectively, when allowing a 2-week period of grace, even though at 6 months, 73% and 80% of patients had refilled five of the six monthly prescriptions [12]. Non-persistence is commonly considered as stopping medication for 1 month for daily or weekly treatment [13]. Gap lengths for osteoporosis treatments with longer dosing intervals are less well defined, though stopping treatment for 2 months may be a suitable definition for a monthly treatment, and a delay of more than 3 months in the case of yearly injections was discussed by the working group.…”