ObjectiveBisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare but serious side effect of bisphosphonates (BPs). Since this disease has no independent code in either of the diseases’ or in the medical procedures’ classifications, it is hard to estimate how many BP patients are affected.DesignA retrospective observational epidemiological registry-based study was carried out, using the data of the national service of Hungary on the incidence of BRONJ and related factors.SettingA data analysis was performed, which is relevant for the whole Hungarian population from 2010 to 2014. The socioeconomic and medication data of 236 207 BP patients were analysed, and a method was worked out to define BRONJ patients from the Hungarian BP population.Primary and secondary outcome measuresThe incidences of BRONJ were analysed according to genders and the types of the BP drugs administered. The marginal interdependence between the types of BP drugs, modes of administration and main indication was calculated.Results340 BP patients (0.1%) developed BRONJ. The incidence of BRONJ in Hungary in the malignant indication of BPs is 0.9%, and 0.1% in the non-malignant indication, and the OR to develop BRONJ was OR=9.7 (95% CI 7.8 to 12.1) between them. Although more women developed BRONJ, the proportion of men was significantly higher than that of women. Steroids increase the risk of jaw osteonecrosis, and differences were also found between the BP drugs.ConclusionsOncology indicated, intravenously administered and steroid comedicated BP therapies pose a high risk of developing BRONJ in the Hungarian population.

In ageing populations, osteoporosis is a serious problem. Low adherence to osteoporotic therapies is a well-known fact. There is a crisis in the therapy of osteoporosis: even with a diagnosis of osteoporosis or after an osteoporotic fracture there are patients without adequate therapy. The aim of the study was to analyse the association between the patientsí subjective importance of osteoporosis and medication adherence, quality of life, depression status and self-reported socioeconomic factors, and find the risk groups which can be identified in the community pharmacy setting to improve the quality of care of osteoporotic patients. A cross-sectional study was conducted in four public hospitals in Hungary. Medication adherence was measured by the Morisky Medication Adherence Scale, quality of life was measured by the EQ5D-3L, depression status was checked by the Beck Depression Scale. Patients were asked to what extent their life was affected by osteoporosis compared to their chronic co-morbidities. Three patient groups were analysed: High, Low and No osteoporosis importance groups. Statistical analyses were carried out by SPSS program. Significant differences were found between the groups of osteoporosis importance in age, T-score, working status, type of the medication, existing fracture, frequency of pain and number of chronic diseases. The main target of pharmaceutical therapy management is to maintain a therapy-length lasting, periodic contact with the osteoporotic patient to improve the patientsí subjective perception of the quality of life. Improving the importance of the disease in patients with low osteoporosis importance could help to improve the patientsí quality of life.