Background The adherence to osteoporosis'medication don't exceed 50% at one year.
Objectives To improve patient's follow up care and adhesion thanks to the creation of a cooperation between the general physician and the dispensary pharmacist and to shown levers and obstacles of a successful cooperation between general physician and dispensary pharmacist in order to improve patients' compliance.
Methods Each patient is asked to participate in a therapeutic education session and receive a follow-up care's logbook containing 6 questionnaires to be completed by the physician and 6 questionnaires to be completed by the pharmacist. The questionnaire “physician” broaches lifestyles' changes, the questionnaire “pharmacist” approaches drugs intake. The patient should pass his logbook to his general physician and his dispensary pharmacist twice a year during 3 years.One meeting a year is organized between physicians and pharmacists to update the protocol, address current diagnosis and therapeutics alternatives.The inclusions started in January 2013 and questionnaires' results were studied at 6 months and 1 year. We interviewed 10 physicians and 10 pharmacists for a semi-directed meeting to assess obstacles and levers of interprofessional cooperation
Results The setting up of a “physician/pharmacist” team should be made by peer-to-peer knowledge. The main levers which gathers the team of experts are annual coordination meeting, follow-up care's logbook. Also an important factor is the patient himself who should be active and framed. Nevertheless, this study highlights two major hard controlled obstacles: the geographical remoteness and the lack of time. Treatment compliance: 49 patients were included in 2013. Every patient received complete information about the treatment and knows exactly its use. 65 among them are still continuing their treatment after 1 year of whom 8 hadn't give back their questionnaires. The analysis of the 27 received questionnaires (at 1 year) shows a rate of compliance with medicinal treatments of 100%, a sufficient supply of dietary calcium's rate of 85% versus 74% after 6 months. It also revealed a sufficient ground balance of 92% versus 77% after 6 months. 96% of these patients comply with the treatment intake's terms, 92% respected the treatment completion versus 75% after 6 months and 89% of them know what to do in case they've forget their treatment. We recorded that 21% of the patients had wanted to stop their treatment due to secondary effects, constraints too important or lake of perceptible effects, versus 9% after 6 months but they didn't stop after a physician or pharmacist consult. 68% of patients know the duration of the treatment. Concerning their lifestyle, we noted that 11% of the patients improved their physical activity level and 78% remained at the same level they were before. Questionnaires' results showed that 56% of the patients expressed their concern about osteoporosis.Six patients stopped the treatment after secondary effects appeared (e.g: dental, ophthalmologic complications)Four patients voluntarily withdraw from the study and 2 patients dropped out.
Conclusions Out of the 49 patients included in this study, 70% pursue the treatment and 12% stopped it because of the secondary effects. This study shows that good physician/pharmacist cooperation improves the compliance with treatment and the lifestyles' changes.
Disclosure of Interest None declared