{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T04:16:13Z","timestamp":1778991373450,"version":"3.51.4"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2010,10,11]],"date-time":"2010-10-11T00:00:00Z","timestamp":1286755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Medication compliance may be a surrogate for factors that improve health outcomes such as fractures. Little is known about the size of this potential \u201chealthy adherer\u201d effect. We evaluated the hypothesis that compliance with placebo is associated inversely with bone loss and fractures among women participating in the Fracture Intervention Trial (FIT). Compliance with placebo and alendronate was evaluated using daily medication diaries. Women were defined as having high compliance if they took 80% or more of dispensed study medication. Change in bone mineral density (BMD) was assessed using mixed models comparing women with high versus lower compliance with placebo. Cox proportional-hazards models analyzed the association between placebo compliance and various types of fractures. Among 3169 women randomized to placebo, 82% had high compliance. Compared with women with lower placebo compliance, bone loss at the total hip was lower in compliant placebo-treated women (\u22120.43%\/year versus \u22120.58%\/year, p\u2009=\u2009.04). Among placebo-treated women, there were 46 hip, 110 wrist, 77 clinical vertebral, and 492 total clinical fractures. Compared with women with lower placebo compliance, women with high placebo compliance had a nonsignificant reduced risk for hip fracture [adjusted hazard ratio (HR)\u2009=\u20090.67, 95% confidence interval (CI) 0.30\u20131.45]. This trend was not observed for other fractures. Medication compliance may be a proxy for factors that confers benefit on reducing hip fracture (but not other types of fractures) independent of the effect of the medication itself. Nonrandomized studies of interventions designed to maintain or improve bone density and\/or hip fracture may need to consider medication compliance as a confounder to better estimate true intervention effects. \u00a9 2011 American Society for Bone and Mineral Research.<\/jats:p>","DOI":"10.1002\/jbmr.274","type":"journal-article","created":{"date-parts":[[2010,10,11]],"date-time":"2010-10-11T19:39:19Z","timestamp":1286825959000},"page":"683-688","source":"Crossref","is-referenced-by-count":38,"title":["The relationship between bisphosphonate adherence and fracture: Is it the behavior or the medication? Results from the placebo arm of the fracture intervention trial"],"prefix":"10.1093","volume":"26","author":[{"given":"Jeffrey R","family":"Curtis","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA"},{"name":"Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Delzell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lang","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine","family":"Ensrud","sequence":"additional","affiliation":[{"name":"Department of Medicine, Minneapolis Veterans Administration Medical Center, Minneapolis, MN, USA"},{"name":"Department of Medicine and Epidemiology, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Judd","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL. USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika M","family":"Safford","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann V","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas C","family":"Bauer","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2010,10,11]]},"reference":[{"key":"2024020318075178900_bib1","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1359\/jbmr.080418","article-title":"The benefit of adherence with bisphosphonates depends on age and fracture type: results from an analysis of 101,038 new bisphosphonate users","volume":"23","author":"Curtis","year":"2008","journal-title":"J Bone Miner Res."},{"key":"2024020318075178900_bib2","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.4065\/81.8.1013","article-title":"Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases","volume":"81","author":"Siris","year":"2006","journal-title":"Mayo Clin Proc."},{"key":"2024020318075178900_bib3","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1007\/s00198-007-0466-1","article-title":"Loss of treatment benefit due to low compliance with bisphosphonate therapy","volume":"19","author":"Penning-van Beest","year":"2008","journal-title":"Osteoporos Int."},{"key":"2024020318075178900_bib4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s00198-006-0230-y","article-title":"Compliance with osteoporosis drug therapy and risk of fracture","volume":"18","author":"Weycker","year":"2007","journal-title":"Osteoporos Int."},{"key":"2024020318075178900_bib5","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1359\/jbmr.080510","article-title":"Fracture outcomes related to persistence and compliance with oral bisphosphonates","volume":"23","author":"Gallagher","year":"2008","journal-title":"J Bone Miner Res."},{"issue":"(2 Suppl)","key":"2024020318075178900_bib6","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.amjmed.2008.12.002","article-title":"Impact of osteoporosis treatment adherence on fracture rates in North America and Europe","volume":"122","author":"Siris","year":"2009","journal-title":"Am J Med."},{"key":"2024020318075178900_bib7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1136\/bmj.38875.675486.55","article-title":"A meta-analysis of the association between adherence to drug therapy and mortality","volume":"333","author":"Simpson","year":"2006","journal-title":"BMJ."},{"key":"2024020318075178900_bib8","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/aje\/kwm070","article-title":"Adherence to lipid-lowering therapy and the use of preventive health services: an investigation of the healthy user effect","volume":"166","author":"Brookhart","year":"2007","journal-title":"Am J Epidemiol."},{"key":"2024020318075178900_bib9","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1161\/CIRCULATIONAHA.108.824151","article-title":"Statin adherence and risk of accidents: a cautionary tale","volume":"119","author":"Dormuth","year":"2009","journal-title":"Circulation."},{"key":"2024020318075178900_bib10","doi-asserted-by":"crossref","first-page":"4118","DOI":"10.1210\/jcem.85.11.6953","article-title":"Fracture risk reduction with alendronate in women with osteoporosis: the Fracture Intervention Trial. 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