The current state of the problem of treatment adherence in patients with osteoporosis

Compliance with the recommendations of a health professional by patients with chronic diseases is observed only in 50% of cases, and therefore, the problem of compliance is very relevant. The widespread occurrence of osteoporosis (OP) in Russia and the world, as well as the existing problem of reducing patient compliance, requires an analysis of existing data on the level of treatment adherence in patients with OP.

The aim. To analyze the current state of adherence to therapy in patients with OP.

Materials and methods. The article provides an overview of the available publications on the mentioned objective. Various databases and search engines were used to search for research by Russian and foreign authors: elibrary.ru, CyberLeninka, Russian National Library (RNB), PubMed, Scientific&Scholarly Research Database (Scilit), Google Academy. The information was searched by keywords and phrases: “osteoporosis”, “osteoporosis”, “adherence to therapy/treatment”, “adherence to treatment”, “compliance”, “compliance”, as well as the corresponding MeSH terms.

Results. The current state of the OP problem has been studied, and the pharmacotherapy currently used in this pathology has been considered. The data on the compliance of patients with OP, the factors that negatively affect the adherence of patients, as well as the methods that contribute to the growth of this indicator, are analyzed, and the expediency of their use is demonstrated.

Conclusion. The problem of adherence to treatment of patients with OP is an important issue of modern healthcare. One of the most effective ways to improve compliance is to increase patients’ awareness of the disease, its course, methods and expediency of pharmacotherapy. There is an urgent need to develop accessible and search for new methods to increase treatment adherence in patients with OP.

1. Balabanova RM, Dubinina TV, Demina AB, Krichevskaya OA. The incidence of musculoskeletal diseases in the Russian Federation over 2015–2016. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2018;56(1):15–21. DOI: 10.14412/1995-4484-2018-15-21

2. Titova EA, Makarova MV, Smirnova AA, Obukhova IV, Ivanova SN. The epidemiological characteristic of diseases of musculoskeletal system. Health Care of the Russian Federation, Russian journal. 2018;62(1):13–17. DOI: 10.18821/0044-197Х-2018-62-1-13-17

3. Kharisyanova EA, Kharisyanov VI. Morbidity incidence of the population by the main classes of diseases in the regions of the Russian Federation. Ufa Humanitarian Scientific Forum. 2024;(4(20)):449–460. DOI: 10.47309/2713-2358-2024-4-449-460

4. Oleynikova TA, Pozhidaeva DN, Oreshko AYu. Prevalence survey of musculoskeletal and connective tissue disorders in the Russian Federation. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2019;12(1):5–13. DOI: 10.17749/2070-4909.2019.12.1.5-13

5. Song S, Guo Y, Yang Y, Fu D. Advances in pathogenesis and therapeutic strategies for osteoporosis. Pharmacol Ther. 2022;237:108168. DOI: 10.1016/j.pharmthera.2022.108168

6. Khandelwal S, Lane NE. Osteoporosis: Review of Etiology, Mechanisms, and Approach to Management in the Aging Population. Endocrinol Metab Clin North Am. 2023;52(2):259–275. DOI: 10.1016/j.ecl.2022.10.009

7. Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993;94(6):646–650. DOI: 10.1016/0002-9343(93)90218-e

8. Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, Hope S, Kanis JA, McCloskey V, Poodle KES, Reid DM, Selby P, Thompson F, Thurston A, Vine N, NOGG. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos. 2017;12:43. DOI: 10.1007/s11657-017-0324-5

9. Sözen T, Özışık L, Başaran N. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4:46–56. DOI: 10.5152/eurjrheum.2016.048

10. Zhu Z, Yu P, Wu Y, Wu Y, Tan Z, Ling J, Ma J, Zhang Jing, Zhu W, Liu Xiao. Sex Specific Global Burden of Osteoporosis in 204 Countries and Territories, from 1990 to 2030: An Age-Period-Cohort Modeling Study. J Nutr Health Aging. 2023;27(9):767–774. DOI: 10.1007/s12603-023-1971-4

11. Zborovskaya IA, Sivordova LE, Rvachev AV, Dmitrenko OS, Ramez Saad Halim, Zavodovsky BV. Retrospective randomized research of frequency of osteoporosis, its risk factors and prevalence of bone fractures in people of Volgograd region. Modern scientific research: problems and prospects. Collection of articles of the international scientific and practical conference. Ufa: OMEGA SCIENCES Limited Liability Company; 2015. P. 192–195. EDN: UEBZEZ. Russian

12. Fomina LA, Zyabreva IA. Epidemiology of osteoporosis and osteopenia. Tver Medical Journal. 2015;1:63–73. EDN: TIMMYJ. Russian

13. Verbovoĭ AF, Pashentseva AV, Sharonova LA. Osteoporosis: Current state of the art. Therapeutic Archive. 2017;89(5):90 97. DOI: 10.17116/terarkh201789590-97

14. Yarikov AV, Smirnov II, Khomchenkov MV, Perlmutter OA, Khokhlov MYu, Galkin AR, Komarov OV, Korochkin DA, Prokopyev VV, Kovalenko NN, Simonov EA, Yaikbaev IP, Lapshin DYu, Gunkin IV, Pavlinov SE, Sosnin AG, Khakhin VB. Osteoporosis: epidemiology, modern methods of diagnosis, prevention and treatment principles. Amur Medical Journal. 2020(2(30)):48-56. EDN: BWMCNV

15. Yershova OB, Sinitsyna OS, Belova KYu, Ganert OA, Romanova MA, Belov MV. Epidemiology of fractures of the proximal femur. Farmateka. 2012;S2:10–16. EDN: SKIOSB. Russian

16. Chung PC, Chan TC. Environmental and personal factors for osteoporosis or osteopenia from a large health check-up database: a retrospective cohort study in Taiwan. BMC Public Health. 2022;22(1):1531. DOI: 10.1186/s12889-022-13938-8

17. Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet. 2019;393(10169):364–376. DOI: 10.1016/S0140-6736(18)32112-3

18. Walker MD, Shane E. Postmenopausal Osteoporosis. N Engl J Med. 2023;389(21):1979–1991. DOI: 10.1056/NEJMcp2307353

19. Dyer SM, Crotty M, Fairhall N, Magaziner J, Beaupre AL, Cameron DI, Sherrington C. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr. 2016;16(1):158. DOI: 10.1186/s12877-016-0332-0

20. Savchenko TN, Agaeva MI, Nosova LA, Shapovalova YuO. Prevention of osteoporosis in women. RMJ. 2017;12:879–883. EDN: ZMYNFZ

21. Koichuev AA. Adherence to treatment: techniques, technologies correcting inadequate adherence to therapy. Medical Bulletin of the North Caucasus. 2013;8(3):65-69. EDN: REMDET

22. Jin J, Sklar GE, Min Sen Oh V, Chuen Li. Factors affecting therapeutic compliance: a review from the patient's perspective. Ther Clin Risk Manag. 2008;4(1):269–286. DOI: 10.2147/tcrm.s1458

23. Shmonin AA, Maltseva MN, Melnikova EV, Ivanova GE. Issues of Compliance with Drug Treatment in Medical Rehabilitation. Doctor.Ru. 2017;11(140):19–26. EDN: ZRXNAB

24. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann CT, Mulrow DC, Shamseer L, Tetzlaff MJ, Akl AE, Brennan ES, Chou R, Glanville J, Grimshaw MJ, Hróbjartsson A, Lalu MM, Li T, Loder WE, Mayo-Wilson E, McDonald S, McGuinness AL, Stewart AL, Thomas J, Tricco CA, Welch AV, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. DOI: 10.1136/bmj.n71

25. Oryan A, Sahvieh S. Effects of bisphosphonates on osteoporosis: Focus on zoledronate. Life Sci. 2021;264:118681. DOI: 10.1016/j.lfs.2020.118681

26. McClung M, Harris ST, Miller PD, Bauer DC, Davison KS, Dian L, Hanley DA, Kendler DL, Yuen CK, Lewiecki EM. Bisphosphonate therapy for osteoporosis: benefits, risks, and drug holiday. Am J Med. 2013;126(1):13–20. DOI: 10.1016/j.amjmed.2012.06.023

27. Drake MT, Clarke BL, Khosla S. Bisphosphonates: mechanism of action and role in clinical practice. Mayo Clin Proc. 2008;83(9):1032–1045. DOI: 10.4065/83.9.1032

28. Adler RA, El-Hajj Fuleihan G, Bauer DC, Camacho PM, Clarke BL, Clines GA, Compston JE, Drake MT, Edwards BJ, Favus MJ, Greenspan SL, McKinney R, Pignolo RJ, Sellmeyer DE. Managing Osteoporosis in Patients on Long-Term Bisphosphonate Treatment: Report of a Task Force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2016;31(1):16–35. DOI: 10.1002/jbmr.2708

29. Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, Gagel RF, Gilsanz V, Guise T, Koka S, McCauley LK, McGowan J, McKee MD, Mohla S, Pendrys DG, Raisz LG, Ruggiero SL, Shafer DM, Shum L, Silverman SL, Van Poznak CH, Watts N, Woo SB, Shane E. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2007;22(10):1479–1491. DOI: 10.1359/jbmr.0707onj

30. Shane E, Burr D Ebeling PR, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster D, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Koval K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O'Keefe R, Papapoulos S, Sen HT, van der Meulen MC, Weinstein RS, Whyte M; American Society for Bone and Mineral Research. Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2010;25(11):2267–2294. DOI: 10.1002/jbmr.253

31. Schilcher J, Michaëlsson K, Aspenberg P. Bisphosphonate use and atypical fractures of the femoral shaft. N Engl J Med. 2011;364(18):1728–1737. DOI: 10.1056/NEJMoa1010650

32. Rudenko EV, Alekna V, Tamulaitiene M, Rudenko EV, Samokhovets OYu, Adamenko AV. Experience with denosumab for the treatment of postmenopausal osteoporosis. Medical news. 2019(10(301)):25–30. EDN: RFLFTE

33. Shalina MA, Yarmolinskaya MI. Experience of using denosumab in the treatment of postmenopausal osteoporosis. Osteoporosis and Bone Diseases. 2016;19(2):84–85. DOI: 10.14341/osteo2016284-85

34. Ostryakova EV, Kuzovkova IV, Paliy PN. The use of teriparatide in combination with denosumab in the treatment of osteoporosis: a description of a clinical case. Collection of abstracts of the VII Russian Congress on Osteoporosis. Part 2. Osteoporosis and osteopathies. 2020;23(2):115. DOI:10.14341/osteo12711

35. Ryabtseva OY. A clinical case of treatment of severe osteoporosis with teriparatide followed by a switch to denosumab. Collection of abstracts of the VII Russian Congress on Osteoporosis. Part 2. Osteoporosis and osteopathies. 2020;23(2):150. DOI:10.14341/osteo12711

36. Kendler DL, Cosman F, Stad RK, Ferrari S. Denosumab in the Treatment of Osteoporosis: 10 Years Later: A Narrative Review. Adv Ther. 2022;39(1):58–74. DOI: 10.1007/s12325-021-01936-y

37. Yuan F, Peng W, Yang C, Zheng J. Teriparatide versus bisphosphonates for treatment of postmenopausal osteoporosis: A meta-analysis. Int J Surg. 2019;66:1–11. DOI: 10.1016/j.ijsu.2019.03.004

38. Mazurov VI, Zhugrova ES, Smakotina AI. Tolerance of teriparatide in patients with severe osteoporosis. Collection of abstracts of the VII Russian Congress on Osteoporosis. Part 2. Osteoporosis and osteopathies. 2020;23(2):88. DOI:10.14341/osteo12711

39. Khovasova NO, Dudinskaya EN, Machekhina LV, Onuchina YuS, Balashova AV, Tkacheva ON. Safety of teriparatide therapy in elderly patients with severe osteoporosis. Osteoporosis and osteopathies. 2022;25(3):134-135. DOI: 10.14341/osteo13114

40. Rozhinskaya LYa, Arapova SD, Dzeranova LK, Molitvoslovova NN, Il'in AV, Sazonova NI, Chernova TO, Shishkina AA, Dedov II, Benevolenskaya LI, Nikitinskaya OA, Korotkova TA, Toroptsova NV, Smirnov AV, Demin NV, Nikolenko VK, Brizhan' LK, Tsibina LV. Investigation of the efficacy and safety of teriparatide (Forsteo) therapy for 1 year in postmenopausal osteoporosis. Osteoporosis and Bone Diseases. 2006;9(2):6–12. DOI: 10.14341/osteo200626-12

41. Mazurenko SO. Teriparatide in the treatment of complications of antiresorptive therapy of osteoporosis (analysis of clinical cases). Collection of abstracts of the VII Russian Congress on Osteoporosis. Part 2. Osteoporosis and osteopathies. 2020;23(2):86. DOI: 10.14341/osteo12711

42. Hirooka Y, Nozaki Y, Inoue A, Li J, Shiga T, Kishimoto K, Sugiyama M, Kinoshita K, Funauchi M, Matsumura I. Effects of denosumab versus teriparatide in glucocorticoid-induced osteoporosis patients with prior bisphosphonate treatment. Bone Rep. 2020;13:100293. DOI: 10.1016/j.bonr.2020.100293

43. Babarina MB, Przhialkovskaya EG, Ulyanova IN. Effective teriparatide treatment of severe osteoporosis of mixed genesis. Collection of abstracts of the VII Russian Congress on Osteoporosis. Part 1. Osteoporosis and osteopathies. 2020;23(1):41. DOI: 10.14341/osteo12703

44. Zazerskaia IE, Kuznetsova LV. Using of strontium ranelate in the treatment of postmenopausal osteoporosis. Problems of Endocrinology. 2011;57(2):46–51. DOI: 10.14341/probl201157246-51

45. Toroptsova NV, Korotkova TA, Toroptsova NV, Korotkova TA. Strontium ranelate in the treatment of osteoporosis: evidence for its efficacy. Rheumatology Science and Practice. 2010;48(1):19–23. DOI: 10.14412/1995-4484-2010-1402

46. Marie PJ. Strontium as therapy for osteoporosis. Curr Opin Pharmacol. 2005;5(6):633–636. DOI: 10.1016/j.coph.2005.05.005

47. Strontium ranelate discontinued. Drug Ther Bull. 2017. DOI: 10.1136/dtb.2017.8.0507

48. Lutsenko AS, Rozhinskaya LY, Toroptsova NV, Belaya ZhE. The role of calcium and vitamin D medications in prevention and treatment of osteoporosis. Osteoporosis and Bone Diseases. 2017;20(2):69–75. DOI: 10.14341/osteo2017269-75

49. Adams JS, Hewison M. Update in Vitamin D. J Clin Endocr Metab. 2010;95(2):471–478. DOI: 10.1210/jc.2009-1773.

50. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J. Prevention of Nonver-tebral Fractures With Oral Vitamin D and Dose Dependency. Arch Intern Med. 2009;169(6):551–561. DOI: 10.1001/archinternmed.2008.600

51. Chiodini I, Bolland MJ. Calcium supplementation in osteoporosis: useful or harmful? Eur J Endocrinol. 2018;178(4):D13–D25. DOI: 10.1530/EJE-18-0113

52. Mazurov VI, Sergeeva AA, Trofimov EA. The role of calcium preparations in the complex treatment of postmenopausal osteoporosis. Medical Council. 2016;5:114–119. DOI: 10.21518/2079-701X-2016-05-114-119

53. Sanaei M, Banasiri M, Shafiee G, Rostami M, Alizad S, Ebrahimi M, Larijani B, Heshmat R. Calcium vitamin D3 supplementation in clinical practice: side effect and satisfaction. J Diabetes Metab Disord. 2016;15:9. DOI: 10.1186/s40200-016-0231-0

54. Nikitinskaya OA, Toroptsova NV. Calcium and vitamin D: an analysis of possible positive and negative side effects in their use. Breast cancer. 2011;19(10):651–655. EDN: QZIXLB. Russian

55. Dragvoll I, Bofin AM, Søiland H, Taraldsen G, Engstrøm MJ. Predictors of adherence and the role of primary non-adherence in antihormonal treatment of breast cancer. BMC Cancer. 2022;22(1):1247. DOI: 10.1186/s12885-022-10362-4

56. Oshotse CO, Bosworth HB, Zullig LL. Treatment Engagement and Adherence. The Wiley Handbook of Healthcare Treatment Engagement. 2020:15–32. DOI: 10.1002/9781119129530.ch1

57. Varenna M. Sinigaglia L. Adherence to treatment of osteoporosis: an open question. Reumatismo. 2009;61(1):4–9. DOI: 10.4081/reumatismo.2009.4

58. Lo A, Lovell KK, Greenzaid JD, Oscherwitz ME, Feldman SR. Adherence to treatment in dermatology: Literature review. JEADV Clin Pr. 2024;3:401–418. DOI: 10.1002/jvc2.379

59. Dobrovolskaya OV, Toroptsova NV. Clinical practice: the place of calcium and vitamin D preparations in the treatment of osteoporosis. Attending physician. 2021;4:26–30. DOI: 10.51793/OS.2021.51.40.005

60. Carbonell-Abella C, Carbonell JT, Martí MM. Adherence in the pharmacological treatment of osteoporosis. Medicina Clínica (English Edition). 2024;162(11):e59–e63. DOI: 10.1016/j.medcle.2024.05.005

61. Nikitinskaya OA, Toroptsova NV, Feklistov AY, Demin NV, Abramkin A. Treatment of patients with osteoporosis in modern clinical practice: adherence to therapy. Osteoporosis and Bone Diseases. 2015;18(1):23–27. DOI: 10.14341/osteo2015123-27

62. Marchenkova LA, Dreval AV, Prokhorova EA, Loseva VA. The adherence of postmenopausal osteoporosis patients to therapy with combination medication contains alendronic acid and colecalciferol and its impact on the effectiveness of treatment. Problems of Endocrinology. 2014;60(4):22–29. DOI: 10.14341/probl201460422-29

63. Degli Esposti L, Giacomini E, Ghigi A, Perrone V. The management of patient with osteoporosis in clinical practice. About Open. 2021;8:1–5. DOI: 10.33393/ao.2021.2198

64. Byun DW, Moon SH, Kim T, Lee HH, Park HM, Kang MI, Ha YC, Chung HY, Yoon BK, Kim TY, Chae SU, Shin CS, Yang KH, Lee JH, Chang JS, Kim SH, Kim IJ, Koh JM, Jung JH, Yi KW, Yoo JJ, Chung DJ, Lee YK, Yoon HK, Hong S, Kim DY, Baek KH, Kim HJ, Kim YJ, Kang S, Min YK. Assessment of patient-reported outcomes (PROs): treatment satisfaction, medication adherence, and quality of life (QoL) and the associated factors in postmenopausal osteoporosis (PMO) patients in Korea. J Bone Miner Metab. 2018;37:563–572. DOI: 10.1007/s00774-018-0956-6

65. Marvin G, Alam GR. A Machine Learning Approach for Predicting Therapeutic Adherence to Osteoporosis Treatment. 2021 IEEE Asia-Pacific Conference on Computer Science and Data Engineering (CSDE), Brisbane, Australia. 2021):1–6. DOI: 10.1109/CSDE53843.2021.9718416

66. Toroptsova NV, Benevolenskaya LI, Toroptsova NV, Benevolenskaya LI. Biophosphonates: adherence to therapy is a pledge of successful treatment for osteoporosis. Modern Rheumatology Journal. 2008;2(1):78–81. DOI: 10.14412/1996-7012-2008-464

67. Pazianas M, Abrahamsen B, Ferrari S, Russell RG. Eliminating the need for fasting with oral administration of bisphosphonates. Therapeutics and Clinical Risk Management. 2013;9:395–402. DOI: 10.2147/tcrm.S52291

68. Marchenkova LA. Reducing Fracture Risk in Postmenopausal Osteoporosis: a Review of Effective and Safe Pharmacological Therapy Providing Adherence to Treatment. Bulletin of Rehabilitation Medicine. 2023;22(4):129–137. DOI: 10.38025/2078-1962-2023-22-4-129-137

69. Kosaka Y, Sugiyama T, Hara K, Kobayashi Y. Adherence to Daily, Weekly, and Monthly Dosing Regimens of Bisphosphonates for Osteoporosis Treatment in Postmenopausal Women in Japan: A Retrospective Study Using Claims Data. Tohoku J Exp Med. 2021;255:147–155. DOI: 10.1620/tjem.255.147

70. Ki̇li̇t TP, Onbaşi K, Özyi̇ği̇t F. Treatment Adherence Levels and Factors Affecting Adherence in Patients Receiving Osteoporosis Treatment. Clin Exp Heal Sci. 2020;10:40–45. DOI: 10.33808/clinexphealthsci.533942

71. Vilms EA, Dobrovolskaya EV, Turchaninova MS, Bykova EA. Analysis of adherence to treatment of patients with osteoporosis in the Omsk region (based on materials from the regional Center for the prevention and treatment of osteoporosis). Osteoporosis and bone diseases. 2020;23(3):17–23. DOI: 10.14341/osteo12695

72. Toroptsova NV. Treatment of patients with osteoporosis: issues of therapy duration, adherence, and replacement. Modern Rheumatology Journal. 2018;12(4):59–64. DOI: 10.14412/1996-7012-2018-4-59-64

73. Yang J, Guo X, Cui Z, Guo H, Dong J-N. Efficacy and safety of denosumab and teriparatide versus oral bisphosphonates to treat postmenopausal osteoporosis: a systematic review and meta-analysis. Front. Endocrinol. 2024;15:1431676. DOI: 10.3389/fendo.2024.1431676

74. Trovas G, Karlafti E, Tournis S, Lampropoulou-Adamidou K, Ibro E, Dontas I. Awareness of osteoporosis and adherence in treatment in Greece. Bone Rep. 2020;13):100551. DOI: 10.1016/j.bonr.2020.100551

75. Roh YH, Koh YD, Noh JH, Gong HS, Baek GH. Effect of health literacy on adherence to osteoporosis treatment among patients with distal radius fracture. Arch Osteoporos. 2017;12:42. DOI: 10.1007/s11657-017-0337-0

76. Yakushevskaya OV. The problem of low adherence to antiresorptive therapy with bisphosphonates: solutions. Medical Council. 2021;(21-1):175-180. DOI: 10.21518/2079-701X-2021-21-1-175-180

77. Danilov A, Shevchenko E. Impact of patient information-educational preparation on clinical, financial, and economic factors and treatment satisfaction. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(2):29–33. DOI: 10.14412/2074-2711-2014-2-29-33

78. Zheleva EG. Healthcare specialist in the process of patient education. Intergenerational relations: modern discourse and strategic choices in psychological and pedagogical science and practice: A collection of articles. Electronic edition, Moscow, July 08-10, 2020. Moscow: Psychological Institute of the Russian Academy of Education; 2020. P. 183–185. EDN: GFTTRO. Russian

79. Gadjiev NK, Gorelov DS, Akopyan GN, Gelig VA, Ivanov AO, Petrov SB, Kryukova NU, Reva SA, Ponomareva YuA, Al-Shukri AS, Mischenko AA, Kogai MA, Vasiliev VN, Chernysheva DYu, Obidnyak VM, Makar’in VA, Pisarev AV, Zakuckij AN, Kuzmin IV, Amdiy RE, Korneyev IA, Al-Shukri SH. «Schools for Patients» with Urolithiasis and Prostatic Diseases. Urology Herald. 2020;8(1):110–120. DOI: 10.21886/2308-6424-2020-8-1-110-120

80. Ustinova VM. Evaluation of the experience of the school for patients with bronchial asthma. Scientific spring 2022. Interuniversity scientific and practical conference of students and young scientists. Bulletin of the medical institute "REAVIZ". Rehabilitation, Doctor and Health. 2022;(2):91–92. Russian

81. Kuznetsov IS. Influence of therapeutic training of patients with osteoporosis on parameters of bone mineral density with various schemes of drug therapy. Osteoporosis and Bone Diseases. 2020;23(2):82. Russian

82. Wilton-Clark MS, Feasel AL, Kline GA, Billington EO. Autonomy begets adherence: decisions to start and persist with osteoporosis treatment after group medical consultation. Arch Osteoporos. 2020;15:1–10. DOI: 10.1007/s11657-020-00809-1

83. Samieva S, Polyakova J, Seewordova L, Papichev E, Akhverdyan Y, Zavodovsky B. POS0580-pare patient adherence to osteoporosis treatment is higher with caregiver education. Ann Rheum Dis. 2023;82:560. DOI: 10.1136/annrheumdis-2023-eular.5918

84. Peeters JJM, van den Berg P, van den Bergh JP, Emmelot-Vonk MH, de Klerk G, Lems WF, Winter EM, Zillikens MC, Appelman-Dijkstra NM. Osteoporosis care during the COVID-19 pandemic in the Netherlands: A national survey. Arch Osteoporos. 2021;16(1):11. DOI: 10.1007/s11657-020-00856-8

85. Kocijan R, Behanova M, Reichardt B, Haschka J, Kocijan A, Zwerina J. Poor adherence to parenteral osteoporosis therapies during COVID-19 pandemic. Arch Osteoporos. 2021;16(1):46. DOI: 10.1007/s11657-021-00904-x

86. Fuggle NR, Singer A, Gill C, Patel A, Medeiros A, Mlotek AS, Pierroz DD, Halbout P, Harvey NC, Reginster JY, Cooper C, Greenspan SL. How has COVID-19 affected the treatment of osteoporosis? An IOF-NOF-ESCEO global survey. Osteoporos Int. 2021;32(4):611–617. DOI: 10.1007/s00198-020-05793-3

87. Malviya R, Sharma A, Gupta R, Awasthi R. Treatment and Prevention of Osteoporosis during COVID-19 Outbreak: Management and Adherence to Treatment Guidelines. Open Public Health J. 2020;13):791–793 DOI: 10.2174/1874944502013010791