Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

Abstract

BackgroundAdherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance.MethodsThis was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis.Results785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]). Patient-rated compliance was highest for monthly bisphosphonates (79.7%) and lowest for hormone substitution therapy (50.0%). Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life.ConclusionCompliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful ways of improving compliance.

GRAND: the German retrospective cohort analysis on compliance and persistence and the associated risk of fractures in osteoporotic women treated with oral bisphosphonates

“…Recent publications suggested several factors which may influence the compliance and persistence with oral bisphosphonate treatments. Lower frequency of treatment regimen of oral bisphosphonates seems to have positive effects on treatment compliance and persistence [42,43]. Psychobehavioural issues may also be relevant factors.…”

“…Psychobehavioural issues may also be relevant factors. For example, gender and individual patient preference may also influence compliance and persistence in patients treated with oral bisphosphonates [42,44]. Other factors may be patient education or the availability of structured disease programs including a more frequent diagnostic monitoring (e.g.…”

“…Other factors may be patient education or the availability of structured disease programs including a more frequent diagnostic monitoring (e.g. densitometry) or supplementary treatment with vitamin D or calcium [42][43][44][45].…”

Gender- and age-related treatment compliance in patients with osteoporosis in Germany

“…To translate this effect into clinical practice, relevant prescribed drugs must be taken on a long-term basis. As a result, one important problem associated with osteoporosis treatment is the lack of compliance of patients affected by this chronic disease 9,16. One must bear in mind that compliance is a complex process that is influenced by a variety of factors related to both patients and physicians 17.…”

Partial adherence: a new perspective on health economic assessment in osteoporosis

“…There are a number of determinants of adherence [18][19][20][21][22]. The determinants of persistence have been studied from the patient's perspective [22] and found to include both internal and external factors.…”