Determinants, consequences and potential solutions to poor adherence to anti-osteoporosis treatment : results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Osteoporosis Foundation (IOF)
Hiligsmann, M. (CAPHRI Care and Public Health Research Institute)
Cornelissen, D. (CAPHRI Care and Public Health Research Institute)
Vrijens, B. (Université de Liège)
Abrahamsen, Bo (University of Southern Denmark)
Al-Daghri, Nasser (King Saud University)
Biver, E. (Hôpitaux Universitaires de Genève)
Brandi, Maria Luisa (Università di Firenze)
Bruyère, Olivier (Université de Liège)
Burlet, N. (Sanofy Lyon)
Cooper, Cyrus (University Hospital Southampton NHS Foundation Trust (Regne Unit))
Cortet, Bernard (Centre Hospitalier Universitaire de Lille)
Dennison, E. M. (University Hospital Southampton NHS Foundation Trust (Regne Unit))
Díez Pérez, Adolfo (Institut Hospital del Mar d'Investigacions Mèdiques)
Gasparik, A. (University of Medicine, Pharmacy, Science and Technology of Targu Mures)
Grosso, A. (Hôpitaux Universitaires de Genève)
Hadji, Peyman (Frankfurt Centre of Bone Health)
Halbout, P. (International Osteoporosis Foundation)
Kanis, John A (University of Sheffield Medical School)
Kaufman, J. M. (Universitair Ziekenhuis Gent)
Laslop, A. (Austrian Federal Office for Safety in Health Care)
Maggi, Stefania (CNR Aging Branch - Institute of Neuroscience, Padova)
Rizzoli, R. (Hôpitaux Universitaires de Genève)
Thomas, T. (CHU Saint-Etienne)
Tuzun, S. (İstanbul University Cerrahpaşa)
Vlaskovska, M. (Medical University Sofia)
Reginster, Jean-Yves (King Saud University)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	Summary: Many patients at increased risk of fractures do not take their medication appropriately, resulting in a substantial decrease in the benefits of drug therapy. Improving medication adherence is urgently needed but remains laborious, given the numerous and multidimensional reasons for non-adherence, suggesting the need for measurement-guided, multifactorial and individualized solutions. Introduction: Poor adherence to medications is a major challenge in the treatment of osteoporosis. This paper aimed to provide an overview of the consequences, determinants and potential solutions to poor adherence and persistence to osteoporosis medication. Methods: A working group was organized by the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal diseases (ESCEO) to review consequences, determinants and potential solutions to adherence and to make recommendations for practice and further research. A systematic literature review and a face-to-face experts meeting were undertaken. Results: Medication non-adherence is associated with increased risk of fractures, leading to a substantial decrease in the clinical and economic benefits of drug therapy. Reasons for non-adherence are numerous and multidimensional for each patient, depending on the interplay of multiple factors, suggesting the need for multifactorial and individualized solutions. Few interventions have been shown to improve adherence or persistence to osteoporosis treatment. Promising actions include patient education with counselling, adherence monitoring with feedback and dose simplification including flexible dosing regimen. Recommendations for practice and further research were also provided. To adequately manage adherence, it is important to (1) understand the problem (initiation, implementation and/or persistence), (2) to measure adherence and (3) to identify the reason of non-adherence and fix it. Conclusion: These recommendations are intended for clinicians to manage adherence of their patients and to researchers and policy makers to design, facilitate and appropriately use adherence interventions.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; altres ; Versió publicada
Matèria:	Adherence ; Determinants ; Osteoporosis ; Persistence ; Solutions
Publicat a:	Osteoporosis International, Vol. 30 Núm. 11 (january 2019) , p. 2155-2165, ISSN 1433-2965

DOI: 10.1007/s00198-019-05104-5
PMID: 31388696

11 p, 318.1 KB

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