As the US Surgeon General C. Everett Koop has said, Selleck AZD5363 “Drugs don’t work in patients who don’t take them….” There has been much concern about the negative AZD6244 solubility dmso consequences of poor compliance and persistence with oral osteoporosis medications. This article will briefly review these issues and, more specifically, will address possible reasons why patients may not take their oral osteoporosis therapies as directed, and suggest some potential solutions and future research. We will focus on oral bisphosphonates since the majority of the prescriptions for a medication for fracture prevention are for

an oral bisphosphonate. Compliance and persistence with therapy What has become apparent in research done during the last few years is that many patients discontinue oral medications for osteoporosis soon after treatment initiation, with a rapid drop in persistence in the first 3 months, followed by a slower decline over ensuing months. For example, persistence on daily bisphosphonate therapy has varied between 25% and 35% persistence at 1 year [1]. Persistence with weekly bisphosphonate therapy at 1 year is between 35% and 45%, a rate not see more substantially better [1]. Some improvement in persistence was seen in one study with monthly bisphosphonate therapy using administrative

claims data, but this improvement has not been confirmed in other studies [2–4]. Adherence to estrogen agonists/antagonists such as raloxifene may be somewhat higher [5], as well as anabolic agents such as teriparitide which require daily subcutaneous injections [6]. The adherence reported to bisphosphonate medications depends on the methodology used, whether medication

possession Tangeritin ratio or persistence over a specific time period is used as well as the definition of the refill gap. This poor persistence seen with oral bisphosphonates does not differ substantially from the persistence to oral medications prescribed for other largely asymptomatic chronic conditions such as hypertension [7] and hypercholesterolemia [8]. Osteoporosis itself is asymptomatic until a fracture occurs, and some patients can have multiple vertebral fractures before symptoms appear. Evidence suggests across multiple therapeutic areas that many patients take drugs incorrectly, infrequently, or not at all. A 2002 Harris Interactive Study [9] showed that approximately 18% of patients taking medications for one or more chronic illnesses had not filled their prescriptions at all, 26% had delayed filling their prescriptions, 14% took a prescription medication in a smaller dose than prescribed, approximately 30% had taken a prescription medication less often than prescribed, and approximately 21% had stopped taking medication sooner than prescribed.