Patient preference in the management of postmenopausal osteoporosis with bisphosphonates

The leading treatments for postmenopausal osteoporosis are the nitrogen-containing bisphosphonates, which are required long term for optimal benefit. Oral bisphosphonates have proven efficacy in postmenopausal osteoporosis in clinical trials, but in practice the therapeutic benefits are often compromised by patients’ low adherence. Nonadherence to bisphosphonate therapy negatively impacts outcomes such as fracture rate; fractures are in turn associated with decreased quality of life. The most common reason cited by patients for their nonadherence is that the strict dosing instructions for bisphosphonates are difficult to follow. One aspect of bisphosphonate administration that can be changed is dosing frequency and several studies have evaluated patient preferences for different dosing schedules. Studies have shown a preference for a weekly bisphosphonate regimen versus daily dosing and it has been demonstrated that this preference for reduced dosing frequency impacts on adherence. Ibandronate is the first nitrogen-containing oral bisphosphonate for osteoporosis that can be administered in a monthly regimen and two robust clinical studies demonstrated a strong patient preference for this monthly regimen versus a weekly regimen. It is important that physicians consider patient preference when prescribing treatment for osteoporosis to ensure that the disease is effectively managed for the long-term benefit of the patient

Prevention and treatment of osteoporosis: avoiding clinical inertia and promoting therapeutic adherence

peer reviewe

The importance of integrating medication adherence into pharmacoeconomic analyses: the example of osteoporosis.

Adherence to medications is poor and suboptimal in many chronic diseases. Nonadherence can reduce treatment effectiveness and can have an impact on healthcare costs. As a consequence, it may alter the cost-effectiveness of drug therapies. This article emphasizes the importance of integrating medication compliance and persistence into pharmacoeconomic evaluations, using osteoporosis as an example. A limited number of studies carried out to date have suggested important economic implications of poor adherence to osteoporosis medications. Therefore, compliance and persistence should be an integral part of clinical studies and pharmacoeconomic analyses in order to estimate the cost-effectiveness of drug therapies in current community practice. Measuring adherence and incorporating it into health economic modeling may, however, pose particular challenges

Adherence to Treatment in Osteoporosis Influence on Efficiency

Low adherence to therapies has been repeatedly described as a major determinant of poor clinical outcomes in chronic disorders. Bisphosphonates, the most widely prescribed drugs in this field, have been linked to a 12-month persistence lower than 40%. The situation is improved when using the weekly formulation compared to the daily intake of the drug. Low compliance results in lesser increase in bone mineral density and decreased anti-fracture efficacy. New medications, currently developed for the management of osteoporosis, will be user-friendly, allowing to an improvement of compliance and persistence.Une faible adhérence a été systématiquement reliée à une moins bonne efficacité thérapeutique, lors de la prise en charge des maladies chroniques. Les bisphosphonates, médicaments les plus largement prescrits pour le traitement de l’ostéoporose, sont grevés d’une persistance à douze mois inférieure à 40%. La situation a été améliorée, de manière insuffisante, par le passage d’une prise quotidienne à une prise hebdomadaire. Une faible observance ou persistance, s’accompagne d’un gain de masse osseuse réduit et d’une moindre efficacité anti-fracturaire. Les nouveaux médicaments actuellement développés dans l’ostéoporose privilégieront le caractère convivial, permettant d’optimaliser l’adhérence au traitement

Adherence to anti-osteoporotic treatment: does it really matter?

peer reviewe