TY - JOUR
T1 - Improving adherence in osteoporosis
T2 - A new management algorithm for the patient with osteoporosis
AU - Baio, Gianluca
AU - Barbagallo, Mario
AU - D'Avola, Giovanni
AU - Di Luccio, Andrea
AU - Di Tanna, Gian Luca
AU - Falaschi, Paolo
AU - Iolascon, Giovanni
AU - Malavolta, Nazzarena
AU - Robbiati, Federico
AU - Ulivieri, Fabio Massimo
PY - 2011/2
Y1 - 2011/2
N2 - 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.
AB - 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.
KW - Adherence
KW - Bisphosphonates
KW - Bone density
KW - Medication possession ratio
KW - Osteoporosis
KW - Treatment algorithm
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UR - http://www.scopus.com/inward/citedby.url?scp=78651467821&partnerID=8YFLogxK
U2 - 10.1517/14656566.2011.537259
DO - 10.1517/14656566.2011.537259
M3 - Article
C2 - 21226636
AN - SCOPUS:78651467821
VL - 12
SP - 257
EP - 268
JO - Expert Opinion on Pharmacotherapy
JF - Expert Opinion on Pharmacotherapy
SN - 1465-6566
IS - 2
ER -