Loss of treatment benefit due to low compliance with bisphosphonate therapy
Summary Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance. These r...
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| Veröffentlicht in: | Osteoporosis international 2008-04, Vol.19 (4), p.511-517 |
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| creator | Penning-van Beest, F. J. A. Erkens, J. A. Olson, M. Herings, R. M. C. |
| description | Summary
Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance. These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.
Introduction
Bisphosphonates are widely used to treat osteoporosis and reduce fracture risk. Low compliance is frequent and will limit treatment benefit.
Methods
New female users of alendronate or risedronate between 1999–2004, aged ≥45 years were identified from PHARMO-RLS, including drug-dispensing and hospitalization data of ≥2 million residents of the Netherlands. Patients were followed until first hospitalisation for an osteoporotic fracture, death, or end of study period. Compliance with bisphosphonates during follow-up was measured over 90-day intervals using Medication Possession Ratio (MPR). The association between compliance and fracture risk was analyzed using time-dependent Cox-regression.
Results
The study cohort included 8,822 new female bisphosphonate users, contributing in total 22,484 person-years of follow-up. During follow-up, 176 osteoporotic fractures occurred (excluding the first six months). Non-compliant bisphosphonate use was associated with a 45% increased fracture risk compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value |
| doi_str_mv | 10.1007/s00198-007-0466-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2267483</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>70396485</sourcerecordid><originalsourceid>FETCH-LOGICAL-c528t-bab1f6bd01eba51580e6858fbe332e4e72022787f26e8101bbe062aaa2f8af6c3</originalsourceid><addsrcrecordid>eNqFkUGLFDEQhYMo7uzoD_AiQdBba1KdTtIXQRZdxQEvCt5C0lPZ6aW70yZpl_33pplhVwXxEFJQX7281CPkGWevOWPqTWKMt7oqZcWElBV_QDZc1HUFrWwekg1ra1W1gn8_I-cpXbMCtq16TM640kow0BvyeRdSosHTHNHmEadMHU7o-0z3C9Ic6BBuaBfGeejt1CG96fOBuj7Nh7CeyeZCHTDa-fYJeeTtkPDp6d6Sbx_ef734WO2-XH66eLerugZ0rpx13Eu3ZxydbXijGUrdaO-wrgEFKmAAxaAHiZoz7hwyCdZa8Np62dVb8vaoOy9uxH1XTEc7mDn2o423Jtje_NmZ-oO5Cj8NgFRC10Xg1Ukghh8LpmzGPnU4DHbCsCSjWN1KoZv_gsC0AlHwLXnxF3gdljiVLRjgWkOjxQrxI9TFsvSI_s4yZ2YN1BwDNWu5Bmp4mXn--1_vJ04JFuDlCbCps4OPJaU-3XHAuJIgROHgyKXSmq4w3jv89-u_AJQ8uZI</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>218825840</pqid></control><display><type>article</type><title>Loss of treatment benefit due to low compliance with bisphosphonate therapy</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Penning-van Beest, F. J. A. ; Erkens, J. A. ; Olson, M. ; Herings, R. M. C.</creator><creatorcontrib>Penning-van Beest, F. J. A. ; Erkens, J. A. ; Olson, M. ; Herings, R. M. C.</creatorcontrib><description>Summary
Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance. These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.
Introduction
Bisphosphonates are widely used to treat osteoporosis and reduce fracture risk. Low compliance is frequent and will limit treatment benefit.
Methods
New female users of alendronate or risedronate between 1999–2004, aged ≥45 years were identified from PHARMO-RLS, including drug-dispensing and hospitalization data of ≥2 million residents of the Netherlands. Patients were followed until first hospitalisation for an osteoporotic fracture, death, or end of study period. Compliance with bisphosphonates during follow-up was measured over 90-day intervals using Medication Possession Ratio (MPR). The association between compliance and fracture risk was analyzed using time-dependent Cox-regression.
Results
The study cohort included 8,822 new female bisphosphonate users, contributing in total 22,484 person-years of follow-up. During follow-up, 176 osteoporotic fractures occurred (excluding the first six months). Non-compliant bisphosphonate use was associated with a 45% increased fracture risk compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value <0.05 for trend). A MPR <20% was associated with an 80% increased fracture risk compared to a MPR ≥90%.
Conclusions
These results show a statistically significant association between level of compliance with bisphosphonates and level of fracture risk, emphasizing the importance of treatment compliance in obtaining maximal treatment benefit.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-007-0466-1</identifier><identifier>PMID: 17874028</identifier><language>eng</language><publisher>London: Springer-Verlag</publisher><subject>Aged ; Biological and medical sciences ; Bone Density - drug effects ; Bone Density - physiology ; Bone Density Conservation Agents - therapeutic use ; Bones, joints and connective tissue. Antiinflammatory agents ; Clinical outcomes ; Cohort Studies ; Diphosphonates - therapeutic use ; Diseases of the osteoarticular system ; Drug Administration Schedule ; Drug therapy ; Endocrinology ; Female ; Follow-Up Studies ; Fractures ; Fractures, Bone - physiopathology ; Fractures, Bone - prevention & control ; Health behavior ; Humans ; Injuries of the limb. Injuries of the spine ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Netherlands ; Original ; Original Article ; Orthopedics ; Osteoporosis ; Osteoporosis, Postmenopausal - drug therapy ; Osteoporosis, Postmenopausal - physiopathology ; Osteoporosis. Osteomalacia. Paget disease ; Pharmacology. Drug treatments ; Rheumatology ; Risk ; Risk Assessment - statistics & numerical data ; Traumas. Diseases due to physical agents ; Treatment Outcome ; Treatment Refusal - psychology ; Treatment Refusal - statistics & numerical data ; Women</subject><ispartof>Osteoporosis international, 2008-04, Vol.19 (4), p.511-517</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2007</rights><rights>2008 INIST-CNRS</rights><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-bab1f6bd01eba51580e6858fbe332e4e72022787f26e8101bbe062aaa2f8af6c3</citedby><cites>FETCH-LOGICAL-c528t-bab1f6bd01eba51580e6858fbe332e4e72022787f26e8101bbe062aaa2f8af6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-007-0466-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-007-0466-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20176244$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17874028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Penning-van Beest, F. J. A.</creatorcontrib><creatorcontrib>Erkens, J. A.</creatorcontrib><creatorcontrib>Olson, M.</creatorcontrib><creatorcontrib>Herings, R. M. C.</creatorcontrib><title>Loss of treatment benefit due to low compliance with bisphosphonate therapy</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>Summary
Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance. These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.
Introduction
Bisphosphonates are widely used to treat osteoporosis and reduce fracture risk. Low compliance is frequent and will limit treatment benefit.
Methods
New female users of alendronate or risedronate between 1999–2004, aged ≥45 years were identified from PHARMO-RLS, including drug-dispensing and hospitalization data of ≥2 million residents of the Netherlands. Patients were followed until first hospitalisation for an osteoporotic fracture, death, or end of study period. Compliance with bisphosphonates during follow-up was measured over 90-day intervals using Medication Possession Ratio (MPR). The association between compliance and fracture risk was analyzed using time-dependent Cox-regression.
Results
The study cohort included 8,822 new female bisphosphonate users, contributing in total 22,484 person-years of follow-up. During follow-up, 176 osteoporotic fractures occurred (excluding the first six months). Non-compliant bisphosphonate use was associated with a 45% increased fracture risk compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value <0.05 for trend). A MPR <20% was associated with an 80% increased fracture risk compared to a MPR ≥90%.
Conclusions
These results show a statistically significant association between level of compliance with bisphosphonates and level of fracture risk, emphasizing the importance of treatment compliance in obtaining maximal treatment benefit.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Bone Density - drug effects</subject><subject>Bone Density - physiology</subject><subject>Bone Density Conservation Agents - therapeutic use</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Clinical outcomes</subject><subject>Cohort Studies</subject><subject>Diphosphonates - therapeutic use</subject><subject>Diseases of the osteoarticular system</subject><subject>Drug Administration Schedule</subject><subject>Drug therapy</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fractures</subject><subject>Fractures, Bone - physiopathology</subject><subject>Fractures, Bone - prevention & control</subject><subject>Health behavior</subject><subject>Humans</subject><subject>Injuries of the limb. Injuries of the spine</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Netherlands</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Osteoporosis</subject><subject>Osteoporosis, Postmenopausal - drug therapy</subject><subject>Osteoporosis, Postmenopausal - physiopathology</subject><subject>Osteoporosis. Osteomalacia. Paget disease</subject><subject>Pharmacology. Drug treatments</subject><subject>Rheumatology</subject><subject>Risk</subject><subject>Risk Assessment - statistics & numerical data</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Treatment Outcome</subject><subject>Treatment Refusal - psychology</subject><subject>Treatment Refusal - statistics & numerical data</subject><subject>Women</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkUGLFDEQhYMo7uzoD_AiQdBba1KdTtIXQRZdxQEvCt5C0lPZ6aW70yZpl_33pplhVwXxEFJQX7281CPkGWevOWPqTWKMt7oqZcWElBV_QDZc1HUFrWwekg1ra1W1gn8_I-cpXbMCtq16TM640kow0BvyeRdSosHTHNHmEadMHU7o-0z3C9Ic6BBuaBfGeejt1CG96fOBuj7Nh7CeyeZCHTDa-fYJeeTtkPDp6d6Sbx_ef734WO2-XH66eLerugZ0rpx13Eu3ZxydbXijGUrdaO-wrgEFKmAAxaAHiZoz7hwyCdZa8Np62dVb8vaoOy9uxH1XTEc7mDn2o423Jtje_NmZ-oO5Cj8NgFRC10Xg1Ukghh8LpmzGPnU4DHbCsCSjWN1KoZv_gsC0AlHwLXnxF3gdljiVLRjgWkOjxQrxI9TFsvSI_s4yZ2YN1BwDNWu5Bmp4mXn--1_vJ04JFuDlCbCps4OPJaU-3XHAuJIgROHgyKXSmq4w3jv89-u_AJQ8uZI</recordid><startdate>20080401</startdate><enddate>20080401</enddate><creator>Penning-van Beest, F. J. A.</creator><creator>Erkens, J. A.</creator><creator>Olson, M.</creator><creator>Herings, R. M. 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J. A. ; Erkens, J. A. ; Olson, M. ; Herings, R. M. C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-bab1f6bd01eba51580e6858fbe332e4e72022787f26e8101bbe062aaa2f8af6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Bone Density - drug effects</topic><topic>Bone Density - physiology</topic><topic>Bone Density Conservation Agents - therapeutic use</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Clinical outcomes</topic><topic>Cohort Studies</topic><topic>Diphosphonates - therapeutic use</topic><topic>Diseases of the osteoarticular system</topic><topic>Drug Administration Schedule</topic><topic>Drug therapy</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fractures</topic><topic>Fractures, Bone - physiopathology</topic><topic>Fractures, Bone - prevention & control</topic><topic>Health behavior</topic><topic>Humans</topic><topic>Injuries of the limb. Injuries of the spine</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Netherlands</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Osteoporosis</topic><topic>Osteoporosis, Postmenopausal - drug therapy</topic><topic>Osteoporosis, Postmenopausal - physiopathology</topic><topic>Osteoporosis. Osteomalacia. Paget disease</topic><topic>Pharmacology. Drug treatments</topic><topic>Rheumatology</topic><topic>Risk</topic><topic>Risk Assessment - statistics & numerical data</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Treatment Outcome</topic><topic>Treatment Refusal - psychology</topic><topic>Treatment Refusal - statistics & numerical data</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Penning-van Beest, F. J. A.</creatorcontrib><creatorcontrib>Erkens, J. A.</creatorcontrib><creatorcontrib>Olson, M.</creatorcontrib><creatorcontrib>Herings, R. M. 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J. A.</au><au>Erkens, J. A.</au><au>Olson, M.</au><au>Herings, R. M. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Loss of treatment benefit due to low compliance with bisphosphonate therapy</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2008-04-01</date><risdate>2008</risdate><volume>19</volume><issue>4</issue><spage>511</spage><epage>517</epage><pages>511-517</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><abstract>Summary
Among 8,822 new female bisphosphonate users, non-compliant bisphosphonate use was associated with a 45% increased risk of osteoporotic fracture compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance. These results emphasize the importance of treatment compliance in obtaining maximal treatment benefit.
Introduction
Bisphosphonates are widely used to treat osteoporosis and reduce fracture risk. Low compliance is frequent and will limit treatment benefit.
Methods
New female users of alendronate or risedronate between 1999–2004, aged ≥45 years were identified from PHARMO-RLS, including drug-dispensing and hospitalization data of ≥2 million residents of the Netherlands. Patients were followed until first hospitalisation for an osteoporotic fracture, death, or end of study period. Compliance with bisphosphonates during follow-up was measured over 90-day intervals using Medication Possession Ratio (MPR). The association between compliance and fracture risk was analyzed using time-dependent Cox-regression.
Results
The study cohort included 8,822 new female bisphosphonate users, contributing in total 22,484 person-years of follow-up. During follow-up, 176 osteoporotic fractures occurred (excluding the first six months). Non-compliant bisphosphonate use was associated with a 45% increased fracture risk compared to compliant use (MPR ≥80%). Classifying compliance into five categories, fracture risk gradually increased with poorer compliance (p-value <0.05 for trend). A MPR <20% was associated with an 80% increased fracture risk compared to a MPR ≥90%.
Conclusions
These results show a statistically significant association between level of compliance with bisphosphonates and level of fracture risk, emphasizing the importance of treatment compliance in obtaining maximal treatment benefit.</abstract><cop>London</cop><pub>Springer-Verlag</pub><pmid>17874028</pmid><doi>10.1007/s00198-007-0466-1</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0937-941X |
| ispartof | Osteoporosis international, 2008-04, Vol.19 (4), p.511-517 |
| issn | 0937-941X 1433-2965 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Aged Biological and medical sciences Bone Density - drug effects Bone Density - physiology Bone Density Conservation Agents - therapeutic use Bones, joints and connective tissue. Antiinflammatory agents Clinical outcomes Cohort Studies Diphosphonates - therapeutic use Diseases of the osteoarticular system Drug Administration Schedule Drug therapy Endocrinology Female Follow-Up Studies Fractures Fractures, Bone - physiopathology Fractures, Bone - prevention & control Health behavior Humans Injuries of the limb. Injuries of the spine Medical sciences Medicine Medicine & Public Health Middle Aged Netherlands Original Original Article Orthopedics Osteoporosis Osteoporosis, Postmenopausal - drug therapy Osteoporosis, Postmenopausal - physiopathology Osteoporosis. Osteomalacia. Paget disease Pharmacology. Drug treatments Rheumatology Risk Risk Assessment - statistics & numerical data Traumas. Diseases due to physical agents Treatment Outcome Treatment Refusal - psychology Treatment Refusal - statistics & numerical data Women |
| title | Loss of treatment benefit due to low compliance with bisphosphonate therapy |
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