***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Background Adherence to anti-osteoporosis treatments is poor , exposing treated women to increased fracture risk . Determinants of poor adherence are poorly understood . The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance . Methods This was an observational , cross-sectional pharmacoepidemiological study with a r and omly-selected sample of 420 GPs , 154 rheumatologists and 110 gynaecologists practicing in France . Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months . Investigators completed a question naire on clinical features , treatments and medical history , and on patient compliance . Patients completed a question naire on sociodemographic features , lifestyle , attitudes and knowledge about osteoporosis , treatment compliance , treatment satisfaction and quality of life .  Treatment compliance was evaluated with the  Morisky Medication-taking Adherence Scale . Variables collected in the question naires were evaluated for association with compliance using multivariate logistic regression analysis . Results 785 women were evaluated . Physicians considered 95.4 % of the sample to be compliant , but only 65.5 % of women considered themselves compliant . The correlation between patient and physician perceptions of compliance was low ( κ : 0.11 [ 95 % CI : 0.06 to 0.16 ] ) . Patient-rated compliance was highest for monthly bisphosphonates ( 79.7 % ) and lowest for hormone substitution therapy ( 50.0 % ) . Six variables were associated with compliance : treatment administration frequency , perceptions of long-term treatment acceptability , perceptions of health consequences of osteoporosis , perceptions of knowledge about osteoporosis , exercise and mental quality of life . Conclusion Compliance to anti-osteoporosis treatments is poor . Reduction of dosing regimen frequency and patient education may be useful ways of improving compliance Background Low adherence to bisphosphonate therapy is associated with increased fracture risk . Factors associated with discontinuation of osteoporosis medications have not been studied in-depth . This study assessed medication discontinuation and switching patterns among Medicare beneficiaries who were new users of bisphosphonates  and evaluated factors possibly associated with discontinuation . Methods We identified patients initiating bisphosphonate treatment using a 5 % r and om sample of Medicare beneficiaries with at least 24 months of traditional fee-for-service and part D drug coverage from 2006 through 2009 . We classified medication status at the end of follow-up as : continued original bisphosphonate , discontinued without switching or restarting , restarted the same drug after a treatment gap ( ≥ 90 days ) , or switched to another anti-osteoporosis medication . We conducted logistic regression analyses to identify baseline characteristics associated with discontinuation and a case-crossover analysis to identify factors that precipitate discontinuation . Results Of 21,452 new users followed respectively for 12 months , 44 % continued their original therapy , 36 % discontinued without switching or restarting , 8 % restarted the same drug after a gap greater than 90 days , and 11 % switched to another anti-osteoporosis medication . Factors assessed during the 12-month period before initiation were weakly associated with discontinuation . Several Factors measured during follow-up were associated with discontinuation , including more physician visits , hospitalization , having a dual-energy X-ray absorptiometry test , higher Charlson comorbidity index scores , higher out-of-pocket drug payments , and upper gastrointestinal problems . Patterns were similar for 4,738 new users followed for 30 months . Conclusions Among  new bisphosphonates users , switching within and across drug classes and extended treatment gaps are common . Robust definitions and time-varying considerations should be considered to characterize medication discontinuation more accurately Summary The goal of this multinational , prospect i ve , observational study was to examine the relationship between gastrointestinal ( GI ) events and self-reported levels of medication adherence and persistence in postmenopausal women . A total of 73.9 % of patients remained on their  osteoporosis ( OP ) therapy at month 12 , although the presence of a GI event at baseline , month 3 , and month 6 significantly reduced month 12 persistence among new users . The odds of a month-12 ADEOS score ≥ 20 were significantly lower among patients who experienced a GI event between baseline and month 6 . The occurrence of GI events was observed to be associated with a lower likelihood of patient adherence and persistence to OP medication . Introduction This study examines the relationship between gastrointestinal ( GI ) events and self-reported adherence and persistence with initial osteoporosis ( OP ) therapy over the course of the first 12 months of treatment . Methods The Medication Use Patterns , Treatment Satisfaction , and Inadequate Control of Osteoporosis Study was a multinational , prospect i ve , observational study examining the impact of GI events on OP management in postmenopausal women . Information regarding GI events was collected at the time of enrollment and at months 3 , 6 , and 12 of follow-up . Patients reported GI events and medication persistence and completed the 12-item Adherence Evaluation of Osteoporosis treatment ( ADEOS ) question naire . Multivariate logistic and general linear models examined the association between GI events at various time points and persistence and adherence at month 12 . Results The study enrolled 2943 women ; 22.8 % were classified as new users of OP therapy and the remainder were considered experienced users . Across all patients , 68.1 % reported GI events at baseline ; by month 12 , over 80 % of subjects who completed follow-up reported at least one GI problem . The majority of patients ( 86.7 % ) were treated only with bisphosphonates at baseline . At month 12 , 73.9 % of patients remained on therapy ; logistic regression revealed that those with GI problems by month 6 were significantly less likely to persist with treatment , after adjusting for other factors . The odds of a month 12 ADEOS score ≥ 20 ( considered predictive of adherence ) were significantly lower among patients who experienced a GI event between baseline and month 6 . Conclusions The occurrence of GI events was associated with a lower likelihood of patient adherence to and persistence with OP medication Background There is significant morbidity and mortality caused by the complications of osteoporosis , for which ageing is the greatest epidemiological risk factor . Preventive medications to delay osteoporosis are available , but little is known about motivators to adhere to these in the context of a symptomless condition with evidence based on screening results . Aim To describe key perceptions that influence older women 's adherence and persistence with prescribed medication when identified to be at a higher than average risk of fracture . Design of Study A longitudinal qualitative study embedded within a multi-centre trial exploring the effectiveness of screening for prevention of fractures . Setting Primary care , Norfolk . United Kingdom Methods Thirty older women aged 70–85 years of age who were offered preventive medication for osteoporosis and agreed to undertake two interviews  at 6 and 24 months post-first prescription . Results There were no overall predictors of adherence which varied markedly over time . Participants ' perceptions and motivations to persist with medication were influenced by six core themes : underst and ing adherence and non-adherence , motivations and self-care , appraising and prioritising risk , anticipating and managing side effects , problems of underst and ing , and decision making around medication . Those engaged with supportive professionals could better tolerate and overcome barriers such as side-effects . Conclusions Many issues are raised following screening in a cohort of women who have not previously sought advice about their bone health . Adherence to preventive medication for osteoporosis is complex and multifaceted . Individual participant underst and ing , choice , risk and perceived need all interact to produce unpredictable patterns of usage and acceptability . There are clear implication s for practice and health professionals should not assume adherence in any older women prescribed medication for the prevention of osteoporosis . The beliefs and motivations of participants and their healthcare providers regarding the need to establish acceptable medication regimes is key to promoting and sustaining adherence Summary The Medication Use Patterns , Treatment Satisfaction , and Inadequate Control of Osteoporosis Study ( MUSIC-OS ) is a prospect i ve , observational study of women with osteoporosis in Europe and Canada . At baseline , patients with gastrointestinal symptoms reported lower adherence to  osteoporosis treatment  , treatment satisfaction , and health-related quality of life , than those without gastrointestinal symptoms . Introduction The aim of the study was to examine gastrointestinal ( GI ) symptoms and the association between GI symptoms and treatment adherence , treatment satisfaction , and health-related quality of life ( HRQoL ) among osteoporotic women in Europe and Canada . Methods Baseline results are reported here for a prospect i ve study which enrolled postmenopausal , osteoporotic women who were initiating ( new users ) or continuing ( experienced users ) osteoporosis treatment at study entry ( baseline ) . A patient survey was administered at baseline and included the occurrence of GI symptoms during 6-month pre-enrolment , treatment adherence ( adherence evaluation of osteoporosis ( ADEOS ) , score 0–22 ) , treatment satisfaction ( Osteoporosis Treatment Satisfaction Question naire for Medications ( OPSAT-Q ) , score 0–100 ) and HRQoL ( EuroQol-5 dimension ( EQ-5D ) utility , score 0–1 ; OPAQ-SV , score 0–100 ) . The association between GI symptoms and ADEOS ( experienced users ) , OPSAT-Q ( experienced users ) , and HRQoL ( new and experienced users ) was assessed by general linear models adjusted for patient characteristics . Results A total of 2959 patients ( 2275 experienced and 684 new users ) were included . Overall , 68.1 % of patients experienced GI symptoms in the past 6 months . Compared with patients without GI symptoms , patients with GI symptoms had lower mean baseline scores on most measures . The mean adjusted differences were ADEOS , −0.43 ; OPSAT-Q , −5.68 ; EQ-5D , −0.04 ( new users ) and −0.06 ( experienced users ) , all P < 0.01 . GI symptoms were also associated with lower OPAQ-SV domain scores : physical function , −4.17 ( experienced users ) ; emotional status , −4.28 ( new users ) and −5.68 ( experienced users ) ; back pain , −5.82 ( new users ) and −11.33 ( experienced users ) , all P < 0.01 . Conclusions Patients with GI symptoms have lower treatment adherence and treatment satisfaction and worse HRQoL than patients without GI symptoms Aim : The aim of the following study is to evaluate adherence and compliance of postmenopausal osteoporotic patients for different regimens of bisphosphonates ( BP ) . Material s and Methods : A prospect i ve observational r and omized comparative 1 year study was undertaken to evaluate the adherence/compliance rates of most commonly prescribed daily alendronate ( ALN ) , weekly risedronate ( RIS ) and monthly ib and ronate ( IBN ) BP regimens . Results : Nearly 40 % was the 1 year adherence rate with BP and 41.33 % of non-compliance . Whereas , 8.66 % was interrupted compliance rate and 6 % switched over to other anti-osteoporotic treatment . The three treatment arm did not vary significantly . However , numerically maximum adherence rate of 56 % was recorded in monthly BP regimen followed by weekly ( 36 % ) and daily regimen ( 32 % ) . Medication possession rate confirmed on a follow-up visit was maximum with monthly regimen as 84.61 % followed by daily ( 62.5 % ) and weekly ( 61.11 % ) respectively . Average time in days for non-adherence was 48 , 56 and 92 day with daily ALN , weekly RIS and monthly IBN regimen respectively . Age , mean age at menopause , demographical profile failed to influence the adherence . Concomitant treatment for co-morbid condition ( 57.14 % ) , unawareness about osteoporosis ( OP ) ( 50 % ) , cost of treatment ( 45.33 % ) , belief that drugs is for their general disability ( 39.28 % ) , physician 's failure to stress the need and necessary calcium + vitamin D daily requirement ( 23.80 % ) each were the most prevalent factors responsible for non-adherence . Intolerance and adverse drug reactions were responsible for only 13.09 % and 11.90 % of non-adherence . Conclusion : Treatment compliance is poor with daily ALN , weekly RIS and monthly IBN regimen along with calcium and vitamin D3 in Indian paramedical workers suffering OP BACKGROUND Bisphosphonates are effective in the prevention and treatment of osteoporosis , yet their use is suboptimal . OBJECTIVES To measure bisphosphonate compliance among first-time users and identify factors associated with compliance . METHODS We conducted a prospect i ve follow-up of all women aged 45 + in the second largest health management organization in Israel who were prescribed bisphosphonates for the first time . The 4448 women were classified by drug dosage .  Persistence and adherence measures of compliance were calculated for each woman over a 1 year period . RESULTS Mean bisphosphonate 
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Condition-related factors that were associated with poorer medication adherence included polypharmacy , and history of falls was associated with higher medication adherence .
Conclusion This review identified factors associated with poor medication adherence among osteoporotic patients .