Background Numerous studies have demonstrated inadequate adherence and persistence to prescribed therapies for many chronic diseases. Osteoporosis is one of the chronic medical conditions that require prolonged treatment. Poor persistence to therapy in osteoporotic patients resulting in increased risk of fracture.
Objectives To evaluate adherence and persistence with drug therapy in osteoporotic patients during 3 years.
Methods We conducted a prospective study of 134 osteoporotic women (mean age 64±10 years), who visited Research Institute of Rheumatology in 2010. Subjects had not received antiosteoporotic medications in the year prior to the start of the study. They were followed up every 12 months during 3 years by telephone contact for self-reporting about antiosteoporotic treatment.
Results Only 99 (74%) women started the drug treatment. 36 (27%) patients were persisted less than 6 months, 23 (17%) - 12 months, 16 (12%) – 2 years and 24 (18%) – 3 years. 35 (26%) patients never began antiosteoporotic treatment. Among subjects who start the treatment 24% received alfacalcidol, 20% - calcitonin, 12% - ibandronate, 10% - alendronate and stroncium ranelate, 9% zoledronic acid and 7% - risedronate or only supplements of calcium and vitamin D. Mean persistence was 2.4, 1.7, 1.6, 2.1, 1.6, 2.2, 1.1 years for alfacalcidol, calcitonin, ibandronate, alendronate, stroncium ranelate, zoledronic acid and risedronate, respectively. 18% women were switched from one antiosteoporotic medication to another due to side effects, inconvenient dose regimen or the price of medication. Discontinuers were less likely than persistent subjects to visit physician and BMD measurement each year for control of treatment (p<0.05). 7 (5%) patients had fractures during 3-years period, among them 5 women without any antiosteoporotic therapy, 1 – received only supplements of calcium and vitamin D and 1 – calcitonin.
Conclusions Our study showed that less than 1/2 of patients received antiosteoporotic drugs during one year and less than 1/5 - three years. Visits to the physician and BMD measurements increased subject's persistence. To improve the quality of medical care to OP patients physicians have to educate and motivate them for a long-term treatment to reduce risk of fractures.
Disclosure of Interest None declared
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