Overcoming non-adherence presents particular challenges in asymptomatic bone diseases and other chronic, asymptomatic
conditions. In such settings, the level of perceived threat to Seliciclib research buy health does not motivate the RG-7388 price patient to adhere to therapy. In addition, risk of non-adherence with any therapy increases with increased duration of treatment . Poor adherence to medication is associated with adverse effects on outcomes in osteoporosis or osteopenia, and non-adherent patients have smaller decreases in rates of bone turnover, smaller gains in BMD and a significantly greater risk of fracture [182, 250–252]. Partial adherence also has a significant impact on cost-effectiveness . Further, research is required to optimize thresholds of compliance and persistence, the impact of gap length,
offset times and fraction of benefit . Improving adherence to osteoporosis therapy requires effective patient/provider communication and close patient monitoring for the early identification of declining adherence. Patients’ belief in a medication contributes to better adherence and can be improved by firmly associating treatment with expected benefits such as reduced risk of fracture and thereby an improved quality of life. Patients may be encouraged to adhere when presented with measurements of biochemical markers of bone turnover or their BMD see more results together with an explanation of how these measures relate to risk reduction. Another primary component of improving adherence is to use simplified or user-friendly treatment programmes [255, 256]. It should be noted that inadequate adherence Endonuclease can also take the form of improper drug administration, even when doses are not missed. An example is the malabsorption of oral bisphosphonates when taken with food. Such non-adherence poses the potential problems of decreased drug absorption and increased
risk of adverse effects . Monitoring of treatment with densitometry The goal of bone-targeted drug therapy in a patient with osteoporosis is to significantly increase bone strength, in order to decrease the risk of fracture. In untreated men and women, BMDis one of the major determinants of bone strength, and low BMD is an important predictor of fracture. Whether the long-term anti-fracture efficacy of anti-osteoporotic drugs depends on the extent to which treatment can increase or maintain BMD is controversial . Meta-regressions, based on summary statistics, demonstrate a stronger correlation between the change in BMD and fracture risk reduction than results based on the individual patient data [259, 260].