Background The treatment of osteoporosis requires regular medication for almost 3 years and a change of lifestyle. Adherence drops to 50% after one year, the change in lifestyle fraught with entrenched habits.
Objectives Programs of therapeutic patient education (TPE) find naturally their place in improving adherence, the acquisition of sufficient calcium-rich diet and regular patient-tailored physical activity.
Methods We have gathered 2 rheumatologists, a chemist, a dietitian, a specialist for physical balance and 2 representatives of a patient association (AFLAR) to develop a program of TPE.After one year, we have identified three main objectives: to ensure maximun adherence to treatment, to ensure the capture of four dairy products a day and to engage patients into various customized workshops so as to increase their physical activities and/or to improve their balance on the ground.We gathered six to seven patients during 3 hours, if possible accompanied by their husband. We have developed games to stimulate the cooperation and the exchange with/between patients and make understanding and acquisiton goals easier.Further to an educational diagnosis collected by questionnaire and individual interview, the session includes a game of the goose for the explanation and the understanding of osteoporosis, how to sort fake food with or without calcium, a questionnaire for calcium intake before and after correction of the deficits, a coffee break with yogurt, a puzzle of healthy bones and osteoporotic bones with parts labeled according to risk factors, exchange about physical activities and how to maintain physical balance. Six months later, we sent a questionnaire to participants to determine their adherence to treatment, and if proper calcium intake and physical activities were maintained. The data were processed by EpiData3,1 and Epi info 3,5,3
Results We spoke to 44 female patients taking oral medication of biphosphonate gathered in sessions of 5 to 6 patients,30% of them being accompanied.We obtained 35 responses: 100% kept on taking their treatment, 29/35 never forgot it, 4/35 rarely forgot it and 2 forgot it often.32/35 patients considered it useful to prevent fractures, 13 to avoid decreasing in size, 12 to keep their autonomy.Only 27/35 were aware of the need to take it a over long time. 20/35 had changed their diet, 35/35 quoted 4 dairy products, 15/35 (4 falling and 11 not falling) have taken precautions to avoid falling. One patient who had fallen did not do anyting to avoid falling, 6 patients both had modified their alimentation and took measures not to fall. Half of them engaged in a physical exercise program and how to keep physical balance which allows no to fall.
Conclusions For the respondants of the questionnaire (35/44), TPE is effective on adherence to treatment, dietary calcium intake,taking precautions against falls, as well as the notion of multi-year follow-up treatment is not always assimilated.The use of games, the presence of the husband, and adoption of time schedules tailored to the elderly have improved the course of the session.Presumably, the results are worse among non-respondents (9/44).TPE, by improving compliance and modification of lifestyle, should avoid fractures, and, therefore, maintain sustained autonomy and reduce costs associated with osteoporosis
Disclosure of Interest None Declared
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