Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment
1 Department of General Practice, UFR Paris 7, Paris, France
2 Rheumatology Department, Poitiers University Hospital, Poitiers, France
3 Rheumatology Department, Montpellier University Hospital, Montpellier, France
4 Rheumatology Department, Roger Salengro Hospital, Lille, France
5 STAT-Process, Port-Mort, France
6 Nukléus, Paris, France
7 Laboratoire GlaxoSmithKline, Marly le Roi, France
8 CERMES, IFR69, INSERM U750, National Institute of Health and Medical Research, Villejuif, France
BMC Women's Health 2010, 10:26 doi:10.1186/1472-6874-10-26Published: 20 August 2010
Adherence 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.
This 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.
785 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.
Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful ways of improving compliance.