Real-world persistence and adherence with oral bisphosphonates for osteoporosis: a systematic review
Objectives
This study examined patient adherence and persistence to oral bisphosphonates for the treatment of osteoporosis in real-world settings.
Methods
A systematic review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) and National Health Service Economic Evaluation Database NHS EED) databases were searched for studies published in English language up to April 2018. Prospective and retrospective observational studies that used prescription claim databases or hospital medical records to examine patient adherence and persistence to oral bisphosphonate treatment among adults with osteoporosis were included. The Newcastle–Ottawa quality assessment scale (NOS) was used to assess the quality of included studies.
Results
The search yielded 540 published studies, of which 89 were deemed relevant and were included in this review. The mean age of patients included within the studies ranged between 53 to 80.8 years, and the follow-up varied from 3 months to 14 years. The mean persistence of oral bisphosphonates for 6 months, 1 year and 2 years ranged from 34.8% to 71.3%, 17.7% to 74.8% and 12.9% to 72.0%, respectively. The mean medication possession ratio ranged from 28.2% to 84.5%, 23% to 50%, 27.2% to 46% over 1 year, 2 years and 3 years, respectively. All studies included scored between 6 to 8 out of 9 on the NOS. The determinants of adherence and persistence to oral bisphosphonates included geographic residence, marital status, tobacco use, educational status, income, hospitalisation, medication type and dosing frequency.
Conclusions
While a number of studies reported high levels of persistence and adherence, the findings of this review suggest that patient persistence and adherence with oral bisphosphonates medications was poor and reduced notably over time. Overall, adherence was suboptimal. To maximise adherence and persistence to oral bisphosphonates, it is important to consider possible determinants, including characteristics of the patients.
Top-30
Journals
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15 publications, 12.2%
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2 publications, 1.63%
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Osteoporosis and Sarcopenia
2 publications, 1.63%
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Journal of Bone and Mineral Research
2 publications, 1.63%
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Archives of Orthopaedic and Trauma Surgery
2 publications, 1.63%
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Current Molecular Medicine
1 publication, 0.81%
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Applied Economics
1 publication, 0.81%
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Journal of Clinical Endocrinology and Metabolism
1 publication, 0.81%
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Global Spine Journal
1 publication, 0.81%
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Therapeutic Advances in Chronic Disease
1 publication, 0.81%
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Frontiers in Pharmacology
1 publication, 0.81%
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Frontiers in Public Health
1 publication, 0.81%
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Endocrine
1 publication, 0.81%
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Journal of Bone and Mineral Metabolism
1 publication, 0.81%
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Systematic Reviews
1 publication, 0.81%
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SSM - Population Health
1 publication, 0.81%
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Transplantation Reports
1 publication, 0.81%
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PLoS ONE
1 publication, 0.81%
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1 publication, 0.81%
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1 publication, 0.81%
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Gerodontology
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Critical Reviews in Food Science and Nutrition
1 publication, 0.81%
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Patient Preference and Adherence
1 publication, 0.81%
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American Journal of Health-System Pharmacy
1 publication, 0.81%
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Publishers
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Springer Nature
60 publications, 48.78%
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Elsevier
16 publications, 13.01%
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Wiley
13 publications, 10.57%
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Taylor & Francis
9 publications, 7.32%
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Frontiers Media S.A.
5 publications, 4.07%
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SAGE
3 publications, 2.44%
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The Endocrine Society
2 publications, 1.63%
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Cold Spring Harbor Laboratory
2 publications, 1.63%
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Bentham Science Publishers Ltd.
1 publication, 0.81%
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Public Library of Science (PLoS)
1 publication, 0.81%
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American Society of Health-System Pharmacists
1 publication, 0.81%
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Tohoku University Medical Press
1 publication, 0.81%
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Korean Society for Bone and Mineral Research
1 publication, 0.81%
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Remedium, Ltd.
1 publication, 0.81%
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Mark Allen Group
1 publication, 0.81%
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Georg Thieme Verlag KG
1 publication, 0.81%
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MDPI
1 publication, 0.81%
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National Medical Research Center For Rehabilitation And Balneology
1 publication, 0.81%
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XMLink
1 publication, 0.81%
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Ovid Technologies (Wolters Kluwer Health)
1 publication, 0.81%
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- We do not take into account publications without a DOI.
- Statistics recalculated weekly.