trials to date suggest potential for improving persistence with medication taking thus improving treatment outcomes and reducing fracture risk .
More precise measurement of medication taking and promoting fidelity to a precisely defined intervention protocol may lead to better assessment of impact on clinical ly important outcomes
BACKGROUND despite availability of effective treatments for osteoporosis , impact on fracture rates may be suboptimal because of failure to adhere to recommended anti-resorptive therapy .
OBJECTIVE to identify r and omized controlled trials ( RCTs ) evaluating interventions intended to improve persistence with anti-resorptive therapy for treating women with osteoporosis or osteopenia .
Treatment persistence with once-monthly ibandronate and patient support vs. once-weekly alendronate: results from the PERSIST study*
Osteoporosis is a common and debilitating condition associated with significant morbidity and mortality . The efficacy and safety of oral bisphosphonates for the treatment of osteoporosis are well established . However , patient adherence and persistence on treatment are suboptimal . This r and omised open-label multi-centre study of 6-months ’ duration compared persistence on treatment in postmenopausal women with osteoporosis receiving either once-monthly ib and ronate plus a patient support programme ( PSP ) , or once-weekly alendronate .  To avoid falsely elevated persistence rates often associated with clinical trials , the study was design ed to reflect everyday clinical practice in the UK and follow-up visits were limited to be consistent with the primary care setting . Analysis of the primary endpoint showed that persistence was significantly higher in the ib and ronate/PSP group compared with the alendronate group ( p < 0.0001 ) . The estimated proportion of patients persisting with treatment at 6 months was 56.6 % ( 306/541 ) and 38.6 % ( 198/513 ) in the ib and ronate/PSP and alendronate groups , respectively . Therefore , compared with alendronate , there was a 47 % relative improvement in the proportion of patients persisting with treatment in the ib and ronate/PSP group . Secondary endpoint measurements of adherence ( e.g. proportion of patients remaining on treatment at study end ; proportion of patients discontinuing from the study ) were also significantly different in favour of ib and ronate plus patient support . In summary , the PERSIST study demonstrated that persistence on treatment was increased in patients receiving once-monthly ib and ronate plus patient support compared with once-weekly alendronate .  Increased persistence on bisphosphonate treatment is expected to improve patient outcomes and decrease the social and economic burden of osteoporosis
trials to date suggest potential for improving persistence with medication taking thus improving treatment outcomes and reducing fracture risk .
More precise measurement of medication taking and promoting fidelity to a precisely defined intervention protocol may lead to better assessment of impact on clinical ly important outcomes
BACKGROUND despite availability of effective treatments for osteoporosis , impact on fracture rates may be suboptimal because of failure to adhere to recommended anti-resorptive therapy .
OBJECTIVE to identify r and omized controlled trials ( RCTs ) evaluating interventions intended to improve persistence with anti-resorptive therapy for treating women with osteoporosis or osteopenia .