6533b82ffe1ef96bd1295d43

RESEARCH PRODUCT

Improving adherence in osteoporosis: a new management algorithm for the patient with osteoporosis

Giovanni IolasconMario BarbagalloGianluca BaioG. D'avolaAndrea Di LuccioNazzarena MalavoltaFabio Massimo UlivieriDi Tanna GianlucaFederico RobbiatiPaolo Falaschi

subject

medicine.medical_specialtyBone Density Conservation AgentBone densityOsteoporosisAlternative medicineadherence; osteoporosis; treatment algorithm; bone density; medication possession ratio; bisphosphonatesMedication AdherenceClinical ProtocolsCost of IllnessTreatment algorithmmedicineHumansBisphosphonatePharmacology (medical)DosingClinical ProtocolAdverse effectMED/01 - STATISTICA MEDICAOsteoporosis PostmenopausalAdherence bisphosphonates bone density medication possession ratio osteoporosis treatment algorithmMedication possession ratioPharmacologyBone Density Conservation Agentsbusiness.industryOsteoporosiGeneral Medicinemedicine.diseaseAlgorithmCost of IllneClinical trialBone Density Conservation AgentsTreatment OutcomeZoledronic acidAdherenceAdherence; Bisphosphonates; Bone density; Medication possession ratio; Osteoporosis; Treatment algorithm; Algorithms; Bone Density Conservation Agents; Clinical Protocols; Cost of Illness; Female; Humans; Osteoporosis; Osteoporosis Postmenopausal; Treatment Outcome; Medication Adherence; Pharmacology; Pharmacology (medical)Physical therapyOsteoporosisFemaleBone densitybusinessAlgorithmsHumanmedicine.drug

description

Introduction: Bisphosphonates are the first-choice treatment for osteoporosis. They effectively increase bone mineral density, reduce markers of bone resorption, and lower the incidence of new fractures in patients with osteoporosis-related fracture. However, the efficacy observed in clinical trials may not be realized in a real-life setting, partly due to poor adherence to therapy, with a significant worsening of clinical outcomes. Several issues contribute to poor adherence to osteoporosis medication, including inconvenient dosing regimens and concerns about possible adverse events. Although strategies to improve adherence have been investigated, new approaches are required. Areas covered: We review available data and propose a new approach to improve adherence to osteoporosis therapy in clinical practice. We present the current evidence and personal experience from a group of Italian osteoporosis experts. Expert opinion: To improve adherence, we propose a multifaceted approach, which includes the Triad Model suggested by the World Health Organization, direct observed therapy and the use of drugs with longer administration intervals, e.g., zoledronic acid. The integration of these strategies may provide the basis for a marked increase in adherence to osteoporosis therapy, and improved clinical outcomes in a real-life scenario. © 2011 Informa UK, Ltd.

yearjournalcountryeditionlanguage
2011-01-01Expert Opinion on Pharmacotherapy
https://doi.org/10.1517/14656566.2011.537259