THE PROBLEM OF COMPLIANCE WITH TREATMENTS FOR OSTEOPOROSIS

Abstract

Chronic diseases pose a challenge for physicians, since rates of adherence to the prescribed treatment are low and deteriorate with time. Osteoporosis is no exception to this rule. The percentage of patients adhering to antiresortive treatment (hormone replacement, raloxifene, or bisphosphonates) falls substantially during the first year, and continues to decrease thereafter. Non-adherent patients show less inhibition of bone turnover, less gain of bone mineral density, and greater fracture risk. This represents increased costs for the health system, specially due to higher hospitalization rates. There are no useful clinical factors for the prediction of adherence, but any effective strategy to improve it should consider a better patient-doctor relationship, monitoring attendance to scheduled clinic visits, and the use of objective elements to monitor the response to treatment (biochemical markers, bone densitometry). Besides, a simpler therapeutic regimen should improve both adherence and the response to treatment.