Non-adherence to anti-osteoporotic medications in Taiwan: Physician specialty makes a difference

Shan Fu Yu, Tsong Shing Yang, Wen Chan Chiu, Chung Yuan Hsu, Ching Lan Chou, Yu Jih Su, Han Ming Lai, Ying Chou Chen, Chung Jen Chen, Tien Tsai Cheng*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

18 Scopus citations


Adherence to anti-osteoporotic regimens gradually decreases over time. We hypothesized that the determinants of non-compliance or non-persistence at different times vary and identified these differences. We used an outpatient database to retrieve information on anti-osteoporotic medications prescribed by a medical centre in southern Taiwan during 2001-2007. Compliance was defined as a medication possession ratio (MPR) ≥80 %. Persistence was determined as continuous use, allowing for a refill gap of 30 days. A multivariate Cox regression model evaluated potential predictors of non-adherence. A total of 3589 patients were included. In the multivariate analyses, non-compliance for both year 1 and year 2 was more likely in patients with non-vertebral non-hip fractures, respiratory disorders, prescription of the first anti-osteoporotic regimen by an orthopedist; and less likely in patients with follow-up bone densitometry and switched regimens. Risks for non-persistence at year 1 and year 2 were generally similar to those for non-compliance; insurance coverage and malignancy were associated with a lower risk of non-persistence at year 1 and year 2, respectively. In the subgroup with an MPR ≥80 % at year 1, an index prescription by an orthopedist was the only independent predictor of non-compliance and non-persistence at year 2. In conclusion, the positive or negative determinants of non-adherence were different at year 1 and year 2, which indicated that clinicians might deliver effective interventions to improve adherence via different precautions annually. This study also provided evidence that physician specialty had a significant effect on adherence to osteoporosis care.

Original languageEnglish
Pages (from-to)351-359
Number of pages9
JournalJournal of Bone and Mineral Metabolism
Issue number3
StatePublished - 05 2013


  • Medication adherence
  • Osteoporosis
  • Pharmacotherapy
  • Risk factors


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