With respect to prospective collection of data on adherence, however, the ADEOS-12 score did perform well in predicting treatment discontinuation, especially in recently treated women who are less likely to be persistent. Physician judgement was of patient adherence seemed overly optimistic, since they considered 97% of patients to be adherent all or most of the time. As indicated in previous studies, physician judgement of adherence was poorly correlated with patient-reported measures of adherence. This highlights the interest of a simple tool for physicians to use to determine patient adherence, rather than relying uniquely on their

own judgement. The ADEOS-12 presents a number of advantages for the evaluation of treatment Selleck ��-Nicotinamide adherence in women with osteoporosis. Firstly, it provides a disease-specific measure which captures Cediranib cost information on treatment and patient attributes which are pertinent to the disease and which may provide clues to improving adherence. For example,

if non-adherent patients consistently report that recommendations for taking their medication are unclear or difficult to follow (items 18 and 32 of the ADEOS), then this would be an HM781-36B incentive to reformulate the recommendations. Although disease-specific adherence questionnaires have been developed in a few disease areas [42–44]; up to now, no such instrument has been made available for the study of osteoporosis. Secondly, the questionnaire is short and simple to use Carbohydrate (12 items with either two or three potential response modalities) and seems understandable and acceptable to patients since the amount of missing data on returned questionnaires was limited (only two patients completed less than half the items). The scoring is simple and rapid for the rater to perform.

Thirdly, compared with the MMAS, the ADEOS-12 has a richer content, covering multiple aspects of medication use, including perceptions of disease, perceptions of treatment and attitudes to taking medication. Moreover, the score, which ranges over 22 points, offers a more highly resolved estimate of adherence than the four-point MMAS score, whereby different degrees of suboptimal adherence can be identified. In particular, it appeared that the ADEOS-12 index showed a notably less important ceiling effect than the MMAS score, indicating that it may be more able to identify slight deviations from perfect behaviour. Fourthly, the ADEOS-12 score seems to be relatively independent of sociodemographic, clinical and treatment variables, although numerically small, albeit significant, differences were observed for fracture history and treatment duration. This suggests that the ADEOS-12 can provide comparable data from different patient groups and that it is sensitive to psychological variables that may underlie individual differences in adherence, such as treatment expectations, disease perceptions, attitudes to risk, mood and patient–physician relationships [45].