Cedars-Sinai/UCLA/OMC, 8641 Wilshire Blvd., Suite 301, Beverly Hills, CA 90211, USA.
Osteoporos Int. 2011 Jan;22(1):21-6. doi: 10.1007/s00198-010-1274-6. Epub 2010 May 11.
Compliance to oral bisphosphonates is suboptimal, with negative consequences of increased healthcare utilization and less effective fracture risk reduction. Extending dose interval increased adherence only moderately. We used literature derived from multiple chronic conditions to examine the problem of noncompliance with osteoporosis medication. We reviewed the literature on adherence to osteoporosis medication as well as that across multiple chronic conditions to understand what is known about the cause of the poor adherence. Poor compliance to oral medications is due mostly, not to forgetfulness, but to deliberate choice. Gender differences and style of healthcare management also play a role. Preliminary data suggest psychobehavioral interventions may help to improve motivation. We need to understand better reasons for poor compliance before effective interventions can be developed. Forgetfulness is only a small part of poor compliance. Patient preferences must be considered in medication decision making.
口服双膦酸盐的依从性并不理想，这会导致医疗保健利用率增加和骨折风险降低效果不理想等后果。延长剂量间隔只能适度提高依从性。我们利用来自多种慢性病的文献来研究骨质疏松症药物治疗不依从的问题。我们回顾了关于骨质疏松症药物治疗依从性的文献，以及跨越多种慢性病的文献，以了解对不良依从性原因的了解。口服药物治疗的依从性差主要不是因为健忘，而是因为故意选择。性别差异和医疗保健管理方式也起作用。初步数据表明，心理行为干预可能有助于提高动机。在开发有效的干预措施之前，我们需要更好地了解不良依从的原因。健忘只是依从性差的一小部分。在药物决策中必须考虑患者的偏好。
