Staying Power: Hints and Tips

If you agree staying on treatment is a problem in osteoporosis, and/ or would like more information on how to improve adherence and reduce the burden of fracture, please click here*

* Please note, the number of people who click here to request more information will be recorded and this number may be shared with third parties such as the media, patient groups and healthcare professionals to prompt people to address the adherence problem.

Staying Power Dossier

Staying Power: Closing The Adherence Gap In Osteoporosis, developed in May 2006, provides a summary of the international evidence available on the impact of non-adherence.* By highlighting the social, financial and personal implications that arise when so many people fail to adhere to treatment in the long-term, we hope to raise awareness of the real cost of this crucial issue and reprioritise lack of adherence so it is given the attention it deserves.

Download the Staying Power Dossier (PDF, 3.9 MB).

* Adherence is defined as patients taking treatment correctly (compliance) and continuing to take treatment for the recommended amount of time (persistence on therapy)

Dossier Summary

OSTEOPOROSIS: THE ADHERENCE CHALLENGE

Osteoporosis is a serious and widespread disease, affecting one in three women and one in five men over fifty.^1,2,3 Although treatment to reduce the risk of fracture is available, many patients are struggling to stay on their treatment for a beneficial length of time:

By the end of their first year of treatment, up to half of people with osteoporosis will have stopped taking their medication.^4,5

THE IMPLICATIONS OF LACK OF ADHERENCE

Personal Burden

After experiencing a vertebral fracture, less than one third of patients will regain their previous level of mobility and over a third will require constant care⁶
Suffering an initial fracture increases the chances of experiencing another: people who have suffered three or more fractures are 10 times more likely to experience another break⁷
Fractures and their associated complications can be fatal and approximately 25-30% of patients who suffer a hip fracture die within a year⁸

Social Burden

In women over 45, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, heart attack and breast cancer⁹
People who have suffered a fracture may be less able to undertake paid employment and have to rely on friends and relatives to provide care and assistance with everyday activities

Economic Burden

In Europe, the annual direct costs of treating osteoporosis amount to €13.7 billion (US$17billion)¹⁰
By 2050, the worldwide cost burden of osteoporosis is set to increase to €106 billion ($131.5 billion)¹¹

CLOSING THE ADHERENCE GAP

As the ageing population continues to grow, so too will the prevalence of osteoporosis. Therefore, addressing lack of adherence must become a priority, with all those involved in the management of osteoporosis working together to help people stay on their treatment.

It has been demonstrated that acknowledging patient preference can improve adherence:¹² physicians can help empower patients by seeking their input during treatment decisions
Research shows that patients are encouraged to stay on therapy by positive motivation:¹³ physicians can involve patients by explaining the benefits of treatment during consultation
It has been shown that adherence is inversely related to frequency of dosing:¹⁴ physicians can consider dosing frequency and patient preference when discussing treatment options
Patient support groups, family and friends can also encourage people to continue taking their osteoporosis treatment

To read a copy of the Staying Power dossier, please click here (PDF, 3.9 MB).

References

Melton LJ, Chrischilles EA, Cooper C, Lane AW and Riggs BL. Perspective. How many women have osteoporosis? Journal of Bone and Mineral Research 1992; 7 (9): 1005-10
Melton LJ, Atkinson EJ, O'Connor MK, O'Fallon WM and Riggs BL. Bone density and fracture risk in men. Journal of Bone Mineral Research 1998; 13 (12): 1915-23
Kanis JA, Johnell O, Oden A, Sembo I, Redlund-Johnell I, Dawson A et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporosis International 2000; 11 (8): 669-74
Cramer J, Amonkar MM, Hebborn A and Suppapanya N. Does dosing regimen impact persistence with bisphosphonate therapy among postmenopausal osteoporotic women? Journal of Bone Mineral Research 2004; 19 Suppl 1: S448
Ettinger MP, Gallagher R, Amonkar M, Smith JC, and MacCosbe PE. Medication persistence is improved with less frequent dosing of bisphosphonates, but remains inadequate. Arthritis Rheum. 2004; 50 Suppl 1: S513
Milne HW; International Osteoporosis Foundation (IOF) Committee of Scientific Advisors. Invest in your bones: make it or break it. How exercise helps to build and maintain strong bones, prevent falls and fractures, and speed rehabilitation. Osteoporosis Australia and International Osteoporosis Foundation. Sydney (Australia): 2005
Nevitt MC, Ross PD, Palermo L, Musliner T, Genant K and Thompson DE; Fracture intervention trial research group. Association of prevalent vertebral fractures, bone density, and alendronate treatment with incident vertebral fractures: Effect of number and spinal location of fractures. Bone 1999; 25 (5): 613-619
Schrager S. Osteoporosis prevention in primary care. Wisconsin Medical Journal 2003; 102 (3): 52-56
Kanis JA, Delmas P, Burckhardt P, Cooper C and Torgerson D; The European Foundation for Osteoporosis and Bone Disease. Guidelines for diagnosis and management of osteoporosis. Osteoporosis International 1997; 7: 390-406
World Health Organisation Collaborating Centre; International Osteoporosis Foundation (IOF) Committee of Scientific Advisors. Invest in your bones. Osteoporosis in the workplace: the social, economic and human costs of osteoporosis on employees, employers and governments. Liege (Belgium): 2002
Johnell O. The socioeconomic burden of fractures: today and in the 21st century. American Journal of Medicine 1997; 103(2A): 20S-25S
Unson CG, Siccion E, Gaztambide J, Gaztambide S, Mahoney Trella P and Prestwood K. Non-adherence and osteoporosis treatment preferences of older women: a qualitative study. Journal of Women’s Health 2003; 12 (10): 1037-45
IPSOS Health. European Survey of Physicians and Women with Osteoporosis. January – April 2005. Sponsored by Roche/ GSK
Reginster JY and Rabenda V. Adherence to anti-osteoporotic treatment: Does it really matter? Future Rheumatol. 2006; 1 (1): 37-40