Why are millions of European women putting themselves at risk of fracture, study

85 per cent of doctors report osteoporosis patients* stop treatment too early to get full benefit -
communication gap between doctors and patients threatens effectiveness of long-term treatment
8 June 2005, Vienna: A new pan-European survey, launched today by the International Osteoporosis
Foundation (IOF), reveals that while women with osteoporosis do recognise the seriousness of their condition,
a large number stop taking their bone-saving medication - potentially because they don't recognise the real
benefits that treatment offers.1


Eighty five per cent of doctors questioned had prescribed a bisphosphonate, the most commonly prescribed
osteoporosis treatment, to a patient who subsequently stopped taking it.1 Stopping treatment leaves patients at
greater risk of fracture and associated disability, reduced independence and increased mortality. Worryingly,
70 per cent of doctors acknowledge that they do not know why so many patients spontaneously stop taking
their bisphosphonate medication.1


This major new survey aimed to understand the reasons why women with osteoporosis do not stay on
treatment. It showed that 34 per cent of women interviewed either didn't know what the benefits of their
medication were or wrongly thought there were no benefits at all.1 Drawbacks of treatment identified by
women were predominantly related to inconvenience and side effects.1


"This is extremely concerning" said Jean-Yves Reginster, Professor of Epidemiology, Public Health and Health
Economics at the University of Liege, Belgium. "If we are going to have an impact on the overall burden of
osteoporosis it is vital that our patients stay on therapy long term. This survey shows us that while 90 per cent of
women view osteoporosis as a serious condition they don't fully appreciate all the benefits of their treatment.1"


The survey, carried out by IPSOS Health, highlighted some major communication gaps between doctors and
the patients they treat. Three-fifths of patients questioned felt that focussing on the positive outcomes of
treatment - such as knowing they were doing something to help themselves - provided the greatest motivation
for continuing their therapy.1 Conversely, 41 per cent of physicians focussed on negative motivators such as
fear, believing the best way to motivate patients to continue on treatment is to explain or remind them about
the risks and complications of fracture if they abandon treatment.1 A key learning from this research,
therefore, is that providing patients with positive encouragement and reasons for staying on therapy may
provide greater motivation than focussing on the negative outcomes of non-adherence.


In addition, while doctors agree on the importance of long term treatment and 82 per cent said they told
patients to stay on therapy for a minimum of 1-2 years, just over half of patients could not recall being told
how long they should continue their medication.1















The survey shows that where doctors and patients do agree is in relation to how treatments could be
improved. Eight out of 10 doctors believe improvements in osteoporosis treatment are necessary for effective
disease management and three-quarters of those interviewed felt that altering the dosing frequency of
bisphosphonates would have a strong influence on adherence.1 Patients concur, citing reduced side effects and
having to take treatment less often as the top two things they think would improve adherence.1


*Patients taking bisphosphonate treatment.


Dr. Daniel Navid, Chief Executive Officer of the IOF, commented: "This report highlights some clear areas for
improvement in osteoporosis management. Doctors need to better understand the concerns and motivations of
their patients to improve dialogue and the quality of the consultation. While our ultimate aim is to prevent
osteoporotic fractures in the first place, we encourage physicians and patients to communicate more effectively
to ensure that treatment is as effective as possible."


For more information, please visit:
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The research, conducted in January - April 2005, among 500 physicians and 500 osteoporosis patients
(who were currently taking, or had taken, a bisphosphonate) across five countries (France, Germany, Italy,
Spain and the UK) - sought to understand the causes behind the lack of patient adherence to bisphosphonate
treatments, and potential ways in which this problem can be addressed.


About the International Osteoporosis Foundation


The International Osteoporosis Foundation (IOF) is a worldwide organization dedicated to the fight against
osteoporosis. It brings together scientists, physicians, patient societies and corporate partners. Working with
its 170 member societies in 84 locations, and other healthcare-related organizations around the world, IOF
encourages awareness and prevention, early detection and improved treatment of osteoporosis.


Osteoporosis, in which the bones become porous and break easily, is one of the world's most common and
debilitating diseases. The result: pain, loss of movement, inability to perform daily chores, and in many cases,
death. One out of three women over 50 will experience osteoporotic fractures, as will one out of five men.


Unfortunately, screening for people at risk is far from being a standard practice. Osteoporosis can, to a certain
extent, be prevented, it can be easily diagnosed and effective treatments are available.


Find out if you are at risk, take the IOF One Minute Risk Test at:
osteofound


There are many medically-proven treatments for osteoporosis. The International Osteoporosis Foundation
(IOF) does not endorse or recommend any specific treatment. Such decisions must be made by the patient
and the physician.


The Adherence Gap: Why Osteoporosis Patients Don't Continue With Treatment was supported by an
unrestricted educational grant from Roche and GlaxoSmithKline (GSK).


Reference

1 IPSOS Health, European Survey of Physicians and Women with Osteoporosis, January - April 2005. Sponsored by
Roche/GSK


Key Country Specific Results


85% of all physicians interviewed had a patient
discontinue their bisphosphonate therapy

France 83%

Germany 77%

Italy 80%

Spain 90%

UK 96%


60% of physicians surveyed believe that
bisphosphonate treatment should last for at
least 3-5 years

France 55%

Germany 64%

Italy 47%

Spain 40%

UK 94%


34% of patients questioned either didn't know what
the benefits of their tablets were, or wrongly thought
there were no benefits at all

France 37%

Germany 20%

Italy 49%

Spain 33%

UK 31%


7 out of 10 physicians questioned admit to not
knowing why so many patients spontaneously stop
taking their bisphosphonate medication

France 64%

Germany 81%

Italy 61%

Spain 51%

UK 98%


...and yet 51% of patients said that they were not told
for how long they should continue their medication

France 56%

Germany 55%

Italy 29%

Spain 48%

UK 66%


Nine out of 10 patients surveyed acknowledged that
osteoporosis is a serious disease

France 89%

Germany 95%

Italy 95%

Spain 79%

UK 91%


Three-fifths of patients questioned felt that focussing
on the positive outcomes of treatment provided the
greatest motivation for continuing their therapy

France 49%

Germany 65%

Italy 70%

Spain 71%

UK 67%


Three-quarters of physicians felt that altering the
dosing frequency would have a strong influence on
adherence because of the greater convenience it
would offer

France 73%

Germany 84%

Italy 49%

Spain 80%

UK 87%


...along with a similar proportion of physicians

France 78%

Germany 95%

Italy 96%

Spain 79%

UK 93%


41 per cent of physicians believe the best way to motivate patients to continue on treatment is to explain or remind them
about the risks and complications of fracture if they abandon treatment

France 45%

Germany 29%

Italy 46%

Spain 40%

UK 46%


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