Effect of A Patient Reminder Program on Adherence in Postmenopausal Women with Osteoporosis Receiving Oral Bisphosphonate Treatment: A Randomized Clinical Control Trial

Abstract

Poor adherence to oral bisphosphonate therapy remains a major challenge in the treatment of osteoporosis, substantially reducing therapeutic efficacy. While reminder interventions have been proposed as a method to enhance adherence, evidence remains limited. This study aimed to evaluate the impact of written and verbal reminders on medication adherence compared to standard patient care over a 12-month period in a real-world clinical setting. In this randomized controlled study, 180 postmenopausal women diagnosed with osteoporosis were assigned to one of three groups: standard care (control), written reminder, or verbal reminder. Interventions were administered at five standardized time points. Adherence was defined as intake of ≥80% of prescribed weekly doses (≥42 out of 52 doses) and a ≥35% reduction in serum C-terminal telopeptide of type I collagen (CTX) levels from baseline to 12 months. No significant differences in adherence rates were observed between groups: 53.2% in the control group, 52.0% in the written reminder group, and 52.7% in the verbal reminder group (χ2 = 0.014; p = 0.993). Changes in bone mineral density and serum CTX levels were also comparable across groups. The implementation of standardized written or verbal reminder strategy did not result in a statistically significant improvement in adherence to oral bisphosphonate therapy. Further studies are needed to investigate the reasons for low adherence to treatment.