Treatment To Prevent Fractures in Men and Women With Low Bone Density or Osteoporosis: An Update
Treatment Monitoring, Adherence, and Persistence (2 of 3)
Decreased adherence to bisphosphonates is associated with an increased risk of fracture (vertebral, nonvertebral, or both). The strength of evidence is moderate.
In general, RCTs examining bisphosphonates report high levels of adherence (majority over 90%), and trials with raloxifene had adherence rates of 65 to 70 percent. The strength of evidence is moderate.
Observational studies of patients taking bisphosphonates in combination with calcium and vitamin D, however, show that adherence and persistence is poor in many patients. The strength of evidence is high.
Keywords: bone | low bone density | bone density | osteoporosis | fracture | osteopenia | skeletal | bisphosphonate | vertebral | nonvertebral | raloxifene | adherence | calcium | vitamin D | adherence
- Newberry SJ, Crandall CC, Gellad WG, et al. Treatment To Prevent Fractures in Men and Women With Low Bone Density or Osteoporosis: An Update to the 2007 Report. Comparative Effectiveness Review No. 53 (Prepared by the Southern California Evidence-based Practice Center under Contract No. HHSA 290-2007-10062-I). Rockville, MD: Agency for Healthcare Research and Quality; February 2012. AHRQ Publication No. 12-EHC023-EF. Available at www.effectivehealthcare.ahrq.gov/reports/lbd.cfm.
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