Evidence map›Paper›PMID 28602783›Full record

Trial reportJournal of the American Pharmacists Association : JAPhA

Patient-reported reasons for nonadherence to recommended osteoporosis pharmacotherapy.

Sylvie F Hall, Stephanie W Edmonds, Yiyue Lou, Peter Cram, Douglas W Roblin, Kenneth G Saag, Nicole C Wright, Michael P Jones, Fredric D Wolinsky

Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Pharmacists Association : JAPhA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
2.2field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Quality and effectiveness of osteoporosis treatment decision aids: a systematic review and environmental scan.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Pooled it
  2. A systematic review of factors affecting medication adherence among patients with osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018
    Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Article
  7. Follow-on osteoporosis therapy after denosumab discontinuation among Medicare beneficiaries.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. The clinician's guide to prevention and treatment of osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Article
  13. Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 2 countries.

Sylvie F Hall
Stephanie W Edmonds
Yiyue Lou
Peter Cram
Douglas W Roblin
Kenneth G Saag
Nicole C Wright
Michael P Jones
Fredric D Wolinsky
University of Iowa · US

Funding

A Patient Activation Intervention to Enhance Bone HealthR01AG033035 · NIA · UNIVERSITY OF IOWA · PI WOLINSKY, FREDRIC D · 2010 to 2014
$7.0M
Mid-Career Investigator Award (for Kenneth G. Saag, MD, MSc)K24AR052361 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2005 to 2014
$1.7M
Building Musculoskeletal Outcomes Research at the University of IowaK24AR062133 · NIAMS · UNIVERSITY OF IOWA · PI CRAM, PETER M · 2012 to 2016
$594k
NIAMS NIH HHS K24 AR052361NIAMS NIH HHS K24 AR062133NIA NIH HHS R01 AG033035
6 · The paper itself

Abstract

objectivesAs many as one-half of patients recommended for osteoporosis pharmacotherapy do not take their medications. To identify intervention targets, we examined patient characteristics associated with nonadherence to recommended pharmacotherapy and their reasons for nonadherence.

methodsData come from the Patient Activation after DXA Result Notification (PAADRN) study, a randomized controlled trial of 7749 patients aged 50 years or older presenting for dual-energy X-ray absorptiometry (DXA) at 3 health centers in the United States. We focused on the 790 patients who reported receiving a recommendation for new pharmacotherapy at baseline. Using Pearson chi-squared tests for categorical variables, 2-sample t tests for continuous variables, and multivariable multinomial logistic regression, we compared those who reported starting the recommended medication (adherers) with temporary nonadherers and nonadherers on demographics, health habits, DXA impression, 10-year probability of fracture using the assessment tool, and osteoporosis knowledge, and we examined their stated reasons for nonadherence.

resultsMean age was 66.8 years (SD = 8.9); 87.2% were women, and 84.2% were white. One-fourth of patients (24.8%) reported that they did not start their recommended pharmacotherapy. In the unadjusted analyses, the only factor significantly associated with nonadherence was osteoporosis knowledge, with those having better knowledge being less likely to take their medications (P < 0.05). The most common reasons for nonadherence were fear of adverse effects (53.3%), a dislike of taking medicine (25.3%), and the belief that the medication would not help their condition (16.7%).

conclusionOne in 4 patients recommended for osteoporosis pharmacotherapy declined treatment because they feared potential adverse effects, did not like taking medicine, or believed that the medication would not help their condition. Improved patient counseling on the potential adverse effects of osteoporosis treatment and the risk-benefit ratio for these medications may increase adherence.

Indexed as

Drug MonitoringAgedFemaleHumansMaleOdds RatioOsteoporosisPatient ComplianceProbability

Identifiers

PMID28602783
PMCPMC5515491
OpenAlexW2612344714

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.