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Determinants of adherence to osteoporosis treatment in clinical practice. M. Rossini . G. Bianchi . O. Di Munno . S. Giannini . S. Minisola . L. Sinigaglia . S. Adami.
Osteoporos Int (2006) 17: 914–921 DOI 10.1007/s00198-006-0073-6

ORIGINA L ARTI CLE

Determinants of adherence to osteoporosis treatment in clinical practice M. Rossini . G. Bianchi . O. Di Munno . S. Giannini . S. Minisola . L. Sinigaglia . S. Adami

Received: 4 November 2005 / Accepted: 4 January 2006 / Published online: 15 March 2006 # International Osteoporosis Foundation and National Osteoporosis Foundation 2006

Abstract Introduction: Poor adherence to prescribed treatments is widespread in clinical practice and this can lead to potentially life-threatening events. This problem is apparently very common for osteoporosis treatment but the causes of discontinuation and low compliance are complex and poorly defined. Methods: Global adherence to osteoporosis treatment was specifically addressed in a nation-wide survey carried out in 9851 postmenopausal women referred to 141 Italian centres for osteoporosis Authors’ study for the “Treatment of Osteoporosis in clinical Practice” (T.O.P.) Study Group, see Appendix. M. Rossini Rheumatology Unit, University of Verona, Verona, Italy G. Bianchi Rheumatology Unit, Ospedale “Le Colletta”, Arenzano, Genova, Italy O. Di Munno Rheumatology Unit, University of Pisa, Pisa, Italy S. Giannini Department of Internal Medicine, University of Padova, Padova, Italy S. Minisola Department of Clinical Science, University of Roma “La Sapienza”, Rome, Italy L. Sinigaglia Rheumatology Unit, Gaetano Pini Institute, Milano, Italy S. Adami (*) Rheumatologic Rehabilitation, University of Verona, Ospedale di Valeggio, 37067 Verona, Italy e-mail: [email protected] Tel.: +39-045-6338607 Fax: +39-045-7952000

management for a follow-up assessment, at least one year after having been prescribed a treatment with one of the following drugs: calcium±vitamin D supplements alone (CaVitD), hormone replacement therapy (HRT), raloxifene 60 mg (RLX), intramuscular clodronate 100 mg/7-14 days (CLOD), risedronate 5 mg/day (RIS) and alendronate 10mg/daily (ALN10) or 70 mg once weekly (ALN OW). Results: Overall 19.1% of the patients discontinued the prescribed drug before attending the bone mass reevaluations, more than half of them within the first 6 months. The discontinuation rate was significantly different between the treatments. The medications most frequently interrupted within one year were CLOD (28.7%; p