Articles Vol. 67 No. 3 31/03/2026

FACTORS ASSOCIATED WITH ORAL BISPHOSPHONATE ADHERENCE IN OLDER ADULTS WITH OSTEOPOROSIS AT UNIVERSITY MEDICAL CENTER HCMC

Huynh Khoi Nguyen1,2,3,4, Pham Truong Giang2,4, Cao Thanh Ngoc1,2,3,4
1 Department of Internal Medicine and Musculoskeletal Disorders, University Medical Center of Ho Chi Minh City
2 Department of Geriatrics, University of Medicine and Pharmacy of Ho Chi Minh City
3 Khoa Nội Cơ Xương Khớp, Bệnh viện Đại học Y Dược TP Hồ Chí Minh
4 Bộ môn Lão Khoa, Đại học Y Dược TP Hồ Chí Minh
DOI: 10.52163/yhc.v67i3.4593
39 Views
21 Downloads
Keywords
Osteoporosis, Oral bisphosphonate, Medication adherence, MARS-5, Older adults.
Abstract

Objective: This study aims to identify factors associated with adherence to oral bisphosphonate therapy in patients aged ≥60 years with osteoporosis, using the Vietnamese version of the MARS-5 scale, to inform strategies for improving treatment effectiveness in Vietnam.

Methods: A cross-sectional study was conducted at the University Medical Center Ho Chi Minh City between November 2022 and April 2023, enrolling 172 outpatients aged ≥60 years diagnosed with osteoporosis and receiving oral bisphosphonates. Medication adherence was assessed using the validated Vietnamese version of the MARS-5 questionnaire. Demographic, clinical, and knowledge-related variables were collected. Univariate and multivariate logistic regression analyses were performed to identify independent factors associated with adherence.

Results: Among 172 patients (149 females, 23 males; mean age 68.7 ± 6.9 years), multivariate analysis revealed three independent factors significantly associated with adherence: treatment duration ≥12 months (p < 0.001), lack of knowledge about the benefits of medication (p = 0.017), and lack of awareness of fracture complications of osteoporosis (p = 0.022).

Conclusion: Adherence to oral bisphosphonate therapy in older adults is influenced by treatment duration and patient knowledge regarding medication benefits and fracture complications. Regular screening using the MARS-5 scale and enhanced patient education are essential to improve adherence and prevent osteoporotic fractures.

References
[1]
Nguyễn Văn Hiếu, Trần Thị Tô Châu. Đánh giá sự tuân thủ điều trị thuốc Bisphosphonate đường uống ở bệnh nhân loãng xương. Tạp chí Y học Việt Nam 2021;502(Đặc biệt):156-162. (In VIE). Google Scholar
[2]
Gustafsson M, Abramsson L. Adherence to Bisphosphonates among People Admitted to an Orthopaedic and Geriatric Ward at a University Hospital in Sweden. Pharmacy 2018;6(1):20. (In ENG). DOI: 10.3390/pharmacy6010020 Google Scholar
[3]
Hall SF, Edmonds SW, Lou Y, et al. Patient-reported reasons for nonadherence to recommended osteoporosis pharmacotherapy. Journal of the American Pharmacists Association : JAPhA 2017;57(4):503-509. (In eng). DOI: 10.1016/j.japh.2017.05.003. Google Scholar
[4]
Gonnelli S, Caffarelli C, Letizia Mauro G, et al. Retrospective evaluation of persistence in osteoporosis therapy with oral bisphosphonates in Italy: the TOBI study. Aging clinical and experimental research 2019;31(11):1541-1547. (In eng). DOI: 10.1007/s40520-019-01205-7. Google Scholar
[5]
Schousboe JT, Dowd BE, Davison ML, Kane RL. Association of medication attitudes with non-persistence and non-compliance with medication to prevent fractures. Osteoporosis International 2010;21(11):1899-1909. (In ENG). DOI: 10.1007/s00198-009-1141-5. Google Scholar
[6]
Horne R, Weinman J. Self-regulation and Self-management in Asthma: Exploring The Role of Illness Perceptions and Treatment Beliefs in Explaining Non-adherence to Preventer Medication. Psychology & Health 2002;17(1):17-32. (In ENG). DOI: 10.1080/08870440290001502. Google Scholar
[7]
Horne R, Cooper V, Gellaitry G, Date HL, Fisher M. Patients' perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: the utility of the necessity-concerns framework. Journal of acquired immune deficiency syndromes (1999) 2007;45(3):334-41. (In eng). DOI: 10.1097/QAI.0b013e31806910e3. Google Scholar
[8]
Solomon DH, Iversen MD, Avorn J, et al. Osteoporosis telephonic intervention to improve medication regimen adherence: a large, pragmatic, randomized controlled trial. Archives of internal medicine 2012;172(6):477-83. (In eng). DOI: 10.1001/archinternmed.2011.1977. Google Scholar