- Real-world persistence and adherence with oral bisphosphonates is suboptimal.
- Determinants of persistence and adherence included geographic residence, history of fractures, race/ethnicity, income, marital status, medication type and dosing frequency.
Why this matters
- Knowing patient determinants will help maximise persistence and adherence.
- Systematic review of 89 observational (retrospective and prospective) studies, after search of MEDLINE, Allied and Comprehensive Medicine Database, Database of Abstracts of Reviews of Effects.
- RCTs excluded.
- Persistence is defined as the time between initiation and discontinuation.
- Adherence (or medication possession ratio [MPR]) is the number of days' supply received divided by the length of the follow-up period.
- Age of participants ranged from 53 to 80.8 years, with 3 months to 14 years follow-up.
- Mean persistence of oral bisphosphonates ranged from 34.8% to 71.3% for 6 months, 17.7% to 74.8% for 1 year, and 12.9% to 72.0% for 2 years.
- Mean adherence (MPR) ranged from 28.2% to 84.5% over 1 year, 23% to 50% over 2 years, and 27.2% to 46% over 3 years.
- Determinants of persistence and adherence included geographic residence, prior bone mineral density test, history of fractures, race/ethnicity, income, marital status, medication type and dosing frequency.
- Meta-analysis not possible due to heterogeneity.