New IOF guides launched to help osteoporosis patients stay on treatment and avoid painful fractures

IOF has launched two new resources to help tackle the significant worldwide issue of osteoporosis patients not staying on treatment, known as 'non-adherence'.

The International Osteoporosis Foundation (IOF) has launched two new resources to help tackle the significant worldwide issue of osteoporosis patients not staying on treatment, known as ‘non-adherence’. A staggering fifty per cent of patients stop taking their weekly or daily treatment after only one year,1,2,3 leaving themselves at an increased risk of painful broken bones which can result in loss of independence and, in the worst cases, lead to death.

The IOF resources – the Staying Power patient checklist and healthcare professionals’ guide – have been developed in conjunction with international osteoporosis experts and patient groups and are designed to facilitate a dialogue between healthcare professionals and patients to help increase treatment adherence and prevent fractures. The patient checklist will help patients discuss this potentially difficult subject with their doctor and the questions guide will support healthcare professionals identify which patients may find staying on treatment a challenge.

Osteoporosis patient Sophia Edlinger knows first-hand the importance of finding a suitable treatment and staying on therapy: “Taking regular medication for any long-term disease is hard. After being diagnosed with osteoporosis, I stopped taking my treatment. But without protection, my bones got weaker and I suffered several breaks in my spine. If I had talked to my doctor about my problems, I could have avoided suffering painful broken bones. If you find treating your osteoporosis a struggle, don’t wait until you break a bone to take action. Talk to your doctor for advice about staying on treatment and protect your future.”

Although non-adherence is a common problem in osteoporosis, over half of healthcare professionals (60%) are unsure why their patients discontinue treatment.4 The new IOF resources work together to support both healthcare professionals and patients by providing insight into the common reasons why so many patients stop taking their medication.

• Many people with osteoporosis lead a busy and active life and find it difficult to prioritise taking regular medication:
>Two thirds of women say their osteoporosis medication interferes with their life in some way.5

• Patients need assurance their medication will help protect them from fractures to motivate them:
>75% of women say they don’t know for certain if their treatment is working or not.5
>87% of women who stop taking their osteoporosis treatment still keep taking their other medication.4

• Evidence suggests that taking account of patients’ preferences and beliefs improves adherence to treatment6:
>Only half of women feel involved in decisions taken about their treatment.5

• Adherence to treatment is essential to reduce fractures and improve patient outcomes:
>Medical treatments for osteoporosis have been shown to reduce the risk of fractures by over 50%.7

Dr Nansa Burlet, IOF Science Manager, commented: “Having a greater understanding of the attitudes towards staying on therapy will make it easier for doctors and patients to discuss adherence challenges and treatment options. Taking steps to keep patients on treatment will reduce the overwhelming financial burden of fractures, release time for busy healthcare professionals and allow people with osteoporosis to continue to stay independent and lead an active life.”

Both resources are available on the IOF website: [link 780]healthcare professional questions guide[/link] and [link 634]patient checklist.[/link]

More facts about adherence:

• Although treatment needs to be taken over a long period of time to be beneficial, this can be difficult for people with osteoporosis:

>After 6 months, more than a fifth of patients stop taking their treatment1
>After one year, approximately half of patients stop taking their weekly or daily treatment1,2,3
>After two years, over two-thirds of patients on a daily treatment stop their medication11

• Not taking treatment leaves patients at an increased risk of fractures

>Fewer than one third of women who experience a fracture will regain their previous level of mobility and over a third will require constant care12

• By 2050 the worldwide cost burden of osteoporosis is forecast to increase to a minimum of €106 billion (US$131.5 billion)13


1. Reginster JY and Rabenda V. Adherence to anti-osteoporotic treatment: Does it really matter? Future Rheumatol. 2006; 1 (1): 37-40
2. Cramer J, Amonkar MM, Hebborn A and Suppapanya N. Does dosing regimen impact persistence with bisphosphonate therapy among postmenopausal osteoporotic women? Journal Bone Mineral Research 2004; 19 Suppl 1: S448
3. 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
4. IPSOS Health. European Survey of Physicians and Women with Osteoporosis. January – April 2005. Sponsored by Roche/GSK
5. Survey of 1500 PMO patients across Europe, research conducted by QiQ International Ltd, 2007. Sponsored by Roche/GSK
6. 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
7. Delmas PD, Rizzoli R, Cooper C and Reginster JY. Treatment of patients with postmenopausal osteoporosis is worthwhile. Osteoporosis International 2005; 16: 1–5
8. Melton LJ, Chrischilles EA, Cooper C, Lane AW and Riggs BL. Perspective. How many women have osteoporosis? Journal Bone and Mineral Research 1992; 7 (9): 1005-10
9. Melton LJ, Atkinson EJ, O'Connor MK, O'Fallon WM and Riggs BL. Bone density and fracture risk in men. Journal Bone Mineral Research 1998; 13 (12): 1915-23