Adherence to osteoporosis medicines in Estonia-a comprehensive 15-year retrospective prescriptions database study.

Abstract

Medication non-adherence is the number one reason for not obtaining the expected clinical effect of medicines. With osteoporosis treatment, it has been shown that both implementation of treatment and persistence influence the risk of fractures significantly. Long-term adherence to medication in Estonia is to be determined with this study. A 15-year retrospective study was carried out in order to establish initiation, implementation, and persistence of Estonian patients. All new users of osteoporosis medicines were analyzed for all prescriptions they received during the study period. Sufficient adherence to treatment was defined as a patient being dispensed 80% or more prescribed doses for at least 1year. The study period was from 2001 to 2015. Patients (24,652) were included in the study. Of the patients, 93.7% (n=23,091) were women and 6.3% (n=1564) were men. Eighteen percent (4636) were dispensed only one prescription. Of the patients, 44.2% included in the study had medication possession ratio (MPR) ≥80% over follow-up period; 8922 (36.2%) who were prescribed from 2001 to 2015 persisted for 1year with MPR ≥80% and 19.8% persisted for 3years. Forty percent of expenditure on osteoporosis medication was made for treatment courses with insufficient adherence. There is room for improvement in Estonia with medication adherence relating to all three aspects that determine adherence-initiation, implementation, and persistence. This means further efforts are to be made to educate patients and healthcare professionals on realizing the importance of good adherence.