Park Nicollet Osteoporosis Center and Park Nicollet Institute for Research and Education, Park Nicollet Health Services, 3800 Park Nicollet Blvd., Minneapolis, MN 55416, USA.
Curr Osteoporos Rep. 2013 Mar;11(1):21-9. doi: 10.1007/s11914-013-0133-8.
Non-persistence (never starting or stopping medication prematurely) and non-compliance (taking medication inappropriately) with fracture prevention medication among those at high risk of fracture remain significant barriers to optimal reduction of osteoporotic fractures. Current research suggest that for patients to persist and comply with prescriptions for fracture prevention medication, they need to believe that they are at significant risk of fracture, that the prescribed medication can safely reduce their risk of fracture without exposing them to long-term harm, that equally effective non-medicinal therapies are not available, and that they can successfully execute medication use in the context of their daily task demands. Further research is needed to understand; a) the mental models of osteoporosis, fractures, and medications used to treat osteoporosis that patients employ when making decisions as to whether or not to take fracture prevention medication; and b) how patients arbitrage information from various sources (health care providers, family, friends, and other sources) to formulate their beliefs about osteoporosis and medications used to treat it.
非坚持（过早开始或停止药物治疗）和不遵医嘱（不恰当地服用药物）仍然是预防骨折药物在高骨折风险人群中应用的主要障碍，会极大地影响骨质疏松性骨折的预防效果。目前的研究表明，为了让患者坚持并遵医嘱使用预防骨折的药物，他们需要相信自己有发生骨折的高风险，所开处方的药物可以安全地降低骨折风险，而不会给他们带来长期危害，没有同样有效的非药物治疗方法，并且他们能够在日常任务需求的背景下成功执行药物使用。需要进一步的研究来了解：a）患者在决定是否服用预防骨折的药物时所使用的骨质疏松症、骨折和用于治疗骨质疏松症的药物的心理模型；以及 b）患者如何从各种来源（医疗保健提供者、家人、朋友和其他来源）收集信息并对其进行权衡，从而形成他们对骨质疏松症和用于治疗骨质疏松症的药物的看法。
