Trial reportMedical care2011
Placebo adherence, clinical outcomes, and mortality in the women's health initiative randomized hormone therapy trials.
Trial report in Medical care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Can Bisphosphonate Therapy Reduce Overall Mortality in Patients With Osteoporosis? A Meta-analysis of Randomized Controlled Trials.Clinical orthopaedics and related research · 2025Pooled it
- Science of Salt: A regularly updated systematic review of salt and health outcomes studies (April to October 2018).Journal of clinical hypertension (Greenwich, Conn.) · 2019Pooled it
- Does alendronate enhance survival rates in osteoporosis patients? A meta-analysis of randomized controlled trials.Science progressPooled it
- The association between relapse and the outcome of schizophrenia and recurrent psychotic disorders.The British journal of psychiatry : the journal of mental science · 2025Trial
- A new telemonitoring feature for detection of long-term CPAP adherence.Sleep medicine: X · 2025Article
- Unravelling telemonitoring data to predict good NIV quality: the E-QualiNIV study.BMJ open respiratory research · 2025Article
- Long-term health outcomes for patients with obstructive sleep apnea: placing the Agency for Healthcare Research and Quality report in context-a multisociety commentary.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Article
- Strategies to Assess the Effect of Continuous Positive Airway Pressure on Long-Term Clinically Important Outcomes among Patients with Symptomatic Obstructive Sleep Apnea: An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2023Article
- The Challenges of Estimating Causal Effects of Continuous Positive Airway Pressure Therapy from Observational Data.American journal of respiratory and critical care medicine · 2022Article
- Evidence does not confirm that lithium prevents suicide: a reply to BschorEpidemiology and psychiatric sciences · 2022Article
- CPAP adherence and cardiovascular disease: beware of the healthy adherer effect.Sleep & breathing = Schlaf & Atmung · 2020Article
- Duration of Bisphosphonate Drug Holidays and Associated Fracture Risk.Medical care · 2020Observational
- Adherence to anti-osteoporosis medication associated with lower mortality following hip fracture in older adults: a nationwide propensity score-matched cohort study.BMC geriatrics · 2019Article
- Development and validation of the Patient's Health Belief Questionnaire on Psychiatric Treatment.Patient preference and adherence · 2019Article
- Statin use does not protect from fractures: the healthy adherer effect is a plausible explanation in observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- It's Bad-Really Bad-But Does it Matter? Medication Adherence in Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2017Article
- Low Blood Pressure Is Associated With Greater Risk for Cardiovascular Events in Treated Adults With and Without Apparent Treatment-Resistant Hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2017Observational
- Association between teriparatide treatment persistence and adherence, and fracture incidence in Taiwan: analysis using the National Health Insurance Research Database.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Article
- Associations between exemption and survival outcomes in the UK's primary care pay-for-performance programme: a retrospective cohort study.BMJ quality & safety · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundMedication adherence may be a proxy for healthy behaviors and other factors that affect outcomes. Prior studies of the association between placebo adherence and health outcomes have been limited primarily to men enrolled in clinical trials and cardiovascular disease outcomes. We examined associations between adherence to placebo and the risk of fracture, coronary heart disease, cancer, and all-cause mortality in the 2 Women's Health Initiative hormone therapy randomized trials.
methodsPostmenopausal women randomized to placebo with adherence measured at least once were eligible for analysis. Time-varying adherence was assessed by dispensing history and pill counts. Outcome adjudication was based on physician review of medical records. Cox proportional hazards models evaluated the relation between high adherence (≥80%) to placebo and various outcomes, referent to low adherence (<80%).
resultsA total of 13,444 postmenopausal women were under observation for 106,066 person-years. High placebo adherence was inversely associated with most outcomes including hip fracture [hazard ratio (HR), 0.50; 95% confidence interval (CI), 0.33-0.78], myocardial infarction (HR, 0.69; 95% CI, 0.50-0.95), cancer death (HR, 0.60; 95% CI, 0.43-0.82), and all-cause mortality (HR, 0.64; 95% CI, 0.51-0.80) after adjustment for potential confounders. Women with low adherence to placebo were 20% more likely to have low adherence to statins and osteoporosis medications.
conclusionsIn the Women's Health Initiative clinical trials, high adherence to placebo was associated with favorable clinical outcomes and mortality. Until the healthy behaviors and/or other factors for which high adherence is a proxy can be better elucidated, caution is warranted when interpreting the magnitude of benefit of medication adherence.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.