Chodick Gabriel, Moser Sarah Sharman, Goldshtein Inbal
a Medical division , Maccabi Healthcare Services , Tel Aviv , Israel.
b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
Expert Rev Pharmacoecon Outcomes Res. 2016 Jun;16(3):359-70. doi: 10.1586/14737167.2016.1171145. Epub 2016 Apr 12.
Osteoporosis-related fractures at the spine and hip have a substantial impact on mortality, morbidity, and quality of life in older adults worldwide. Adherence to bisphosphonates is essential for effective treatment and fracture prevention. Nevertheless, numerous studies from various populations and study designs clearly indicated that adherence and persistence are poor with more than 50% of patients discontinuing therapy within one year. This is primarily explained by mild adverse effects, dosing regimens, and costs. Studies have also shown that good adherence is associated with reduced osteoporosis-related and non-related healthcare costs as soon as 2 years from therapy initiation. Nonetheless, we found only little improvement in adherence rates over the years. In light of the importance of medication adherence and the limited success of previous programs, other than reducing dosing frequency, new directions should be explored to engage patients and care givers in order to improve adherence and prevent fractures.
脊柱和髋部的骨质疏松相关骨折对全球老年人的死亡率、发病率和生活质量有重大影响。坚持服用双膦酸盐对于有效治疗和预防骨折至关重要。然而，来自不同人群和研究设计的大量研究清楚地表明，依从性和持续性较差，超过50%的患者在一年内停止治疗。这主要是由轻微的不良反应、给药方案和成本所导致的。研究还表明，从治疗开始2年后，良好的依从性与降低骨质疏松相关和非相关的医疗保健成本相关。尽管如此，这些年来我们发现依从率几乎没有提高。鉴于药物依从性的重要性以及先前项目取得的有限成功，除了减少给药频率之外，应该探索新的方向来促使患者和护理人员参与，以提高依从性并预防骨折。
