Background/Purpose: Medication adherence with prescription osteoporosis medications is poor, with approximately half remaining adherent in the first year of treatment. Moreover, approximately one-third who are prescribed an osteoporosis medication do not fill the new prescription. Reasons for the poor initiation and persistence are multiple.  The effect of the recent reports of potential long-term side effects of osteoporosis medications is unknown.

Methods: The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort through which survey data are collected annually from women aged ≥55 years old at baseline. The women were initially recruited from 17 regional sites in 10 different countries.

Results: Of 34,971 women that completed surveys in the fifth year, 3,735 were classified as osteoporosis prescription medication “stoppers” as they had been on an osteoporosis medication but stopped it in the past 2 years; whereas 175 were osteoporosis medication “non-starters” and never initiated an osteoporosis medication despite receiving a prescription from their physician. The majority (52%) of stoppers report they were instructed by their doctor to stop their medication. A large proportion also listed concerns of long-term risks associated with the medication(s) (36%) and a specific concern about effects on teeth or jaw (19%) as reasons for stopping (Table 1). For the non-starters, the majority (55%) listed possible side effects as their reason for not initiating an osteoporosis prescription medication, despite the recommendation from their physician (Table 2).

Conclusion: Osteoporosis medication adherence is known to be poor. Our findings reflect women’s concerns over possible long-term effects of these medications as a major contributor to not taking or starting these medications. However, most women that were taking medications in the past have stopped taking their osteoporosis medication per the instruction of their physician. These findings highlight increasing concerns of patients and their physicians about the safety of osteoporosis medications.

Table 1. Reasons for stopping osteoporosis medications

Table 2. Reasons for NOT starting osteoporosis medications