Generic placeholder image

Current Clinical Pharmacology


ISSN (Print): 1574-8847
ISSN (Online): 2212-3938

General Research Article

Medication Non-adherence in Patients with Osteoporosis: Implications for Clinical Pharmacists and Osteoporosis Care Providers

Author(s): Anan S. Jarab*, Tareq L. Mukattash and Hayat Hilan

Volume 15, Issue 3, 2020

Page: [243 - 250] Pages: 8

DOI: 10.2174/1574884715666200116104754


Background: Poor adherence to the prescribed therapy leads to low bone mineral density and enhance the development of osteoporosis complications and unnecessary hospitalization.

Objective: To explore factors associated with medication non-adherence in patients with osteoporosis. Findings would help guide the development of future pharmaceutical care interventions aim at improving health outcomes for patients with osteoporosis.

Methods: The study was conducted at an outpatient osteoporosis clinic at the Royal Medical Services Hospital. Variables including socio-demographics and medical factors were collected using medical records and custom-designed questionnaire. Medication adherence was assessed using the validated 4-item Morisky Medication Adherence Scale. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with osteoporosis in Jordan.

Results: A total of 296 patients participated in the study. Most of the study participants (72.3%) were found non-adherent. Patients were found less likely to adhere to the prescribed medications with each unit increase in the number of prescribed medications (OR = 2.503, CI = 1.103-5.680) and if they did not have a trust in the efficacy of the medications (OR = 5.544, CI = 0.990-31.058).

Conclusion: Medication adherence for patients with osteoporosis has considered scope for improvement in Jordan. Simplifying dosage regimen in addition to taking patients’ preferences when selecting the medications should be taken into account in future interventions designed to improve health outcomes for patients with osteoporosis.

Keywords: Osteoporosis, medication, fractures, pharmacotherapy, asymptomatic, orthotic, orthopedic, rehabilitation medicine.

Graphical Abstract
Vijayakumar R, Büsselberg D. Osteoporosis: An under-recognized public health problem: Local and global risk factors and its regional and worldwide prevalence. J Local Global Health Sci 2016; 2: 1-13.
Halpern R, Becker L, Iqbal SU, Kazis LE, Macarios D, Badamgarav E. The association of adherence to osteoporosis therapies with fracture, all-cause medical costs, and all-cause hospitalizations: A retrospective claims analysis of female health plan enrollees with osteoporosis. J Manag Care Pharm 2011; 17(1): 25-39.
[] [PMID: 21204588]
Hyassat D, Alyan T, Jaddou H, Ajlouni KM. Prevalence and risk factors of osteoporosis among jordanian postmenopausal women attending the national center for diabetes, endocrinology and genetics in jordan. Biores Open Access 2017; 6(1): 85-93.
World Health Organization. Adherence to long-term therapies: evidence for action 2003.
Boudou L, Gerbay B, Chopin F, Ollagnier E, Collet P, Thomas T. Management of osteoporosis in fracture liaison service associated with long-term adherence to treatment. Osteoporos Int 2011; 22(7): 2099-106.
[] [PMID: 21528360]
Abebaw M, Messele A, Hailu M, Zewdu F. Adherence and associated factors towards antidiabetic medication among type II diabetic patients on follow-up at university of Gondar Hospital. Adv Nurs 2016; 3: 1-7.
Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag Healthc Policy 2014; 7: 35-44.
[PMID: 24591853]
Cadarette SM, Burden AM. Measuring and improving adherence to osteoporosis pharmacotherapy. Curr Opin Rheumatol 2010; 22(4): 397-403.
[] [PMID: 20498602]
Iversen MD, Vora RR, Servi A, Solomon DH. Factors affecting adherence to osteoporosis medications: A focus group approach examining viewpoints of patients and providers. Journal of geriatric physical therapy 2011; 34(2): 72.
Breuil V, Cortet B, Cotté FE, et al. Validation of the Adherence Evaluation of Osteoporosis treatment (ADEOS) questionnaire for osteoporotic post-menopausal women. Osteoporos Int 2012; 23(2): 445-55.
[] [PMID: 21625889]
Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ. Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc 2007; 82(12): 1493-501.
[] [PMID: 18053457]
Recker RR, Gallagher R, MacCosbe PE. Effect of dosing frequency on bisphosphonate medication adherence in a large longitudinal cohort of women. Mayo Clin Proc 2005; 80(7): 856-61.
[] [PMID: 16007889]
Etikan I, Musa SA, Alkassim RS. Comparison of convenience sampling and purposive sampling. Am J Theor Appl Stat 2016; 5(1): 1-4.
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24(1): 67-74.
[] [PMID: 3945130]
Jarab AS, Almrayat R, Alqudah S, et al. Predictors of non-adherence to pharmacotherapy in patients with type 2 diabetes. Int J Clin Pharm 2014; 36(4): 725-33.
[] [PMID: 24805800]
Jarab AS, Alefishat E, Bani Nasur R, Mukattash TL. Investigation of variables associated with medication nonadherence in patients with hypertension. J Pharm Health Serv Res 2019; 9(4): 341-6.
Sylvie FS, Edmonds Y, Cram D, Mapel KG, Saag N, Wright MP. Patient-reported reasons for nonadherence to recommended osteoporosis pharmacotherapy. J Am Pharm Assoc 2017; 57(4): 503-9.
Hadji P, Papaioannou N, Gielen E, et al. Persistence, adherence, and medication-taking behavior in women with postmenopausal osteoporosis receiving denosumab in routine practice in Germany, Austria, Greece, and Belgium: 12-month results from a European non-interventional study. Osteoporos Int 2015; 26(10): 2479-89.
[] [PMID: 26018090]
García-Sempere A, Hurtado I, Sanfélix-Genovés J, et al. Primary and secondary non-adherence to osteoporotic medications after hip fracture in Spain. The PREV2FO population-based retrospective cohort study. Sci Rep 2017; 7(1): 11784.
[] [PMID: 28924156]
Stoica S, Zugravu G. Adherence to bisphosphonates treatment of osteoporosis. Ann Rheum Dis 2014; 73(2): 1075-5.
Gadkari AS, McHorney CA. Unintentional non-adherence to chronic prescription medications: How unintentional is it really? BMC Health Serv Res 2012; 12(1): 98.
[] [PMID: 22510235]
Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: A meta-analytic review of the necessity-concerns framework. PLoS One 2013; 8(12)e80633
[] [PMID: 24312488]
Yood RA, Mazor KM, Andrade SE, Emani S, Chan W, Kahler KH. Patient decision to initiate therapy for osteoporosis: The influence of knowledge and beliefs. J Gen Intern Med 2008; 23(11): 1815-21.
[] [PMID: 18787907]
Nobili A, Garattini S, Mannucci PM. Multiple diseases and polypharmacy in the elderly: challenges for the internist of the third millennium. J Comorbidity 2011; 1(1): 28-44.
Marcum ZA, Gellad WF. Medication adherence to multidrug regimens. Clin Geriatr Med 2012; 28(2): 287-300.
[] [PMID: 22500544]
Dabaghian FH, Rassouli M, Sadighi J, Ghods R. Adherence to prescribed medications of Iranian traditional medicine in a group of patients with chronic disease. J Res Pharm Pract 2016; 5(1): 52-7.
[] [PMID: 26985436]
Geitona M, Latsou D, Toska A, Saridi M. Polypharmacy and adherence among diabetic patients in Greece. Consult Pharm 2018; 33(10): 562-71.
[] [PMID: 30322433]
Mohammed S, Arabi A, El-Menyar A, et al. Impact of polypharmacy on adherence to evidence-based medication in patients who underwent percutaneous coronary intervention. Curr Vasc Pharmacol 2016; 14(4): 388-93.
[] [PMID: 26517700]

© 2022 Bentham Science Publishers | Privacy Policy