OBJECTIVES: To assess the relationship between osteoporosis-related pharmacological treatment use, patterns and adherence and risk of second fracture or death in an Italian real-world setting.

METHODS: A retrospective cohort analysis using a north-eastern Italian region’s administrative database was conducted. Osteoporotic patients with a first hospitalization for fracture of femur with replacement or vertebral column between 1 January 2011 and 30 June 2015 were included. The use of post-fracture treatment, treatment patterns, among antiosteoporosis medication (AOM) and supplementation with calcium or vitamin D (Ca/VitD), and adherence using Medication Possession Ratio(MPR) were analyzed. Cox regression models were used to estimate the risk of incidence of osteoporosis-related re-fractures, among femur with replacement, vertebral column, radius and ulna, and all-cause death from the hospitalization-index until 30 June 2016. Follow-up costs were calculated per patient per year (PPPY).

RESULTS: CONCLUSIONS: This real-world study suggests that the relevance of monitoring of compliance to guidelines in terms of treatment use, patterns and adherence may improve patients' prognosis.