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Current Opinion in Rheumatology

Metabolic bone disease: Edited by Kenneth Saag

Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada

Correspondence to Suzanne M. Cadarette, PhD, Leslie L. Dan Pharmacy Building, University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada Tel: +1 416 978 2993; e-mail: [email protected]

Abstract

Purpose of review 

Osteoporosis is a major public health issue resulting in considerable fracture-related morbidity. Although effective treatment exists, adherence to osteoporosis pharmacotherapy is suboptimal and linked to reduced drug effectiveness. In this paper, we review methods of measuring and improving adherence to osteoporosis pharmacotherapy.

Recent findings 

Most patients will stop osteoporosis pharmacotherapy, yet the majority who discontinue will reinitiate treatment after an extended gap. The key to improving adherence to osteoporosis pharmacotherapy is to reduce the number and length of gaps in treatment. Multifaceted and individualized interventions may help to improve adherence. New strategies aimed at identifying patients likely to stop therapy may also facilitate the development of targeted interventions.

Summary 

Adherence to osteoporosis pharmacotherapy is suboptimal with short periods of persistence and lengthy gaps in therapy. Regular communication regarding the importance of continued therapy is critical. More research to help identify risk profiles of patients likely to become nonadherent, targeted multifaceted interventions to maximize adherence to therapy, and data to support when patients may safely consider a physician directed drug holiday is needed.

© 2010 Lippincott Williams & Wilkins, Inc.