Background The management of osteoporosis requires drug treatment and changes in lifestyle. Adherence to medication does not exceed 50% at one year. Changes in lifestyle are rarely explored. Therapeutic requires a relay to continue the follow-up over several years
Objectives To improve the follow-up of the patient, we have created cooperation between the attending physician and the pharmacy pharmacist initiated by the patient himself
Methods We proposed a therapeutic patient education for patients treated for osteoporosis to participate in two half-day ETP sessions a year apart. Educational objectives are: The treatment of osteoporosis requires at least 5 years of treatment, and must be associated with the absorption of three dairy products per day, maintaining physical activity and preventing falls. Each patient participating in a therapeutic education session receives a follow-up notebook containing six doctor questionnaires and six pharmacist questionnaires. The patient remains the owner of the notebook. We were able to study the results of the 2-year questionnaires for 72 patients included in 2013 and 2014.
Results 53/72 patients continue their treatment at 2 years. 4 patients died, 1 had an atypical fracture of the femoral shaft, 6 stopped treatment due to dental treatment, 3 had contraindications to any anti-osteoporotic treatment, 1 decided to discontinue treatment due to d Multiple Sclerosis, 11 decided to leave the program. 3 patients were lost to follow-up, ie 14/72 patients of whom we no longer have any news. Of the 53 patients who continued treatment, 24 sent back a doctor and pharmacist questionnaire to 2 years. 4 doctors and 2 pharmacists refused to complete the questionnaires. The study of pharmacist questionnaires received at 2 years shows that 83% of patients continue to consume 3 dairy products per day compared to 73% at 6 months, 65% maintained physical activity, 17% improved it, 9% decreased. The ground balance was satisfactory for 78% of patients compared with 71% at 6 months. 71% never forget their treatment, compared with 69% at 6 months. 8% wanted to stop their treatment, stable figure compared to questionnaires received at 6 months. All patients knew what their treatment was for at one year and 96% met the conditions for taking the medication. 69% do not forget it at two years against 86% at one year, thanks to the intervention of the pharmacist. Only 6% wanted to stop the treatment at two years due to side effects, 17% to 1 year, but did not stop after consultation with the doctor and/or pharmacist.
During the two-year follow-up, all patients were phone called at least once by a secretary, mostly several times. The notebook is driven by the patient himself, many oh them report to the nurse that it give them an active role which afoord them to continue the treatment
Conclusions 58% of the patients enrolled continue treatment at two years, 15% have stopped the treatment as a side effect. An active role given to the patient and a collaboration between physicians and pharmacists thus promote adherence to treatment and also changes in lifestyle
Disclosure of Interest None declared