Background Pharmacological treatment in osteoporosis (OP) has been demonstrated as effective in significantly reduction the risk of osteoporotic fracture. However, the effectiveness of this treatment may be compromised by poor treatment compliance and can result in increased rates of fracture1.
Objectives To evaluate patients’ compliance for the treatment of OP, comparing patients in the general population and subjects in a high risk of fracture (HRF) population.
Methods Cross sectional survey was performed including subjects representative of the Portuguese population ≥50 years (selected by random route method, door to door) and HRF population (convenience sample, selected from nursing homes and long term facilities from Portugal). Inclusion criteria for HRF population are age ≥50 years, history of femoral neck fracture on the 24 months prior and absence of cognitive limitations. The general and HRF population included demographics and clinical variables. Patients’ compliance was evaluated through the Morisky scale (range 0-7). It was performed a descriptive analysis of all variables collected, including relative frequencies for categorical variables and mean ± standard deviation for continuous variables. T-test and chi-square test were performed to validate the study hypothesis. All calculations were performed assuming a 5% significance level.
Results This analysis included a total of 2007 subjects from the general population (mean age of 65.3±10.4 years, 55.2% female). 3.1% (n=62; CI: 2.4%>3.9%) had self-reported OP. HRF population included 419 subjects (mean age of 78.3±7.8, 70.4%female). From these, 37.5% (n=157; CI: 32.9%>42.2%) had self-reported OP. In general population with self reported OP 67.7% (n=42) referred being medicated and more than half referred to never forget to take their medication (56.5%; n=26). In HRF population 91.1% (n=143) were medicated for OP and the majority of patients reported never forgetting to take their medication (71.6%; n=106). Globally, the results suggest that HRF population is more compliant than the general population with self-reported OP (Morisky scale value 5.9±0.7 vs. 4.1±1.9; p<0.001). The most significant differences found in each item of the Morisky scale were “Do you forget to take your medicine?” (Yes: 46.5% vs. 2.0%; p<0.001); “Did you ever missed your medication during the last 4 weeks?” (Yes: 48.8% vs. 5.4%; p<0.001); “When you travel or go out of home, do you ever forget to take your medication with you?” (Yes: 44.2% vs. 8.1%; p<0.001); and “Do you ever feel that it is hard to follow your treatment plan for OP?” (Yes: 32.6% vs. 4.1%; p<0.001).
Conclusions Our study proves that OP treatment is poor; especially the HRF population and that compliance is lower in the general population. This behavior may expose patients to higher risk of developing low bone mass and consequent osteoporotic fractures. Patient and physician awareness and education must be stimulated as a useful way of improving compliance with treatment.
Huas D, Debiais F, Blotman F, Cortet B, Mercier F, Rousseaux C, Berger V, Gaudin AF, Cotté FE. Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment. BMC Womens Health. 2010 Aug 20;10:26.
Disclosure of Interest None Declared
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