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Published in: BMC Women's Health 1/2010

Open Access 01-12-2010 | Research article

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

Authors: Dominique Huas, Françoise Debiais, Francis Blotman, Bernard Cortet, Florence Mercier, Chantal Rousseaux, Véronique Berger, Anne-Françoise Gaudin, François-Emery Cotté

Published in: BMC Women's Health | Issue 1/2010

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful ways of improving compliance.
Appendix
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Literature
1.
go back to reference Geusens PP, Roux CH, Reid DM, Lems WF, Adami S, Adachi JD, Sambrook PN, Saag KG, Lane NE, Hochberg MC: Drug Insight: choosing a drug treatment strategy for women with osteoporosis-an evidence--based clinical perspective. Nat Clin Pract Rheumatol. 2008, 4 (5): 240-248. 10.1038/ncprheum0773.CrossRefPubMed Geusens PP, Roux CH, Reid DM, Lems WF, Adami S, Adachi JD, Sambrook PN, Saag KG, Lane NE, Hochberg MC: Drug Insight: choosing a drug treatment strategy for women with osteoporosis-an evidence--based clinical perspective. Nat Clin Pract Rheumatol. 2008, 4 (5): 240-248. 10.1038/ncprheum0773.CrossRefPubMed
2.
go back to reference Tosteson AN, Grove MR, Hammond CS, Moncur MM, Ray GT, Hebert GM, Pressman AR, Ettinger B: Early discontinuation of treatment for osteoporosis. Am J Med. 2003, 115 (3): 209-216. 10.1016/S0002-9343(03)00362-0.CrossRefPubMed Tosteson AN, Grove MR, Hammond CS, Moncur MM, Ray GT, Hebert GM, Pressman AR, Ettinger B: Early discontinuation of treatment for osteoporosis. Am J Med. 2003, 115 (3): 209-216. 10.1016/S0002-9343(03)00362-0.CrossRefPubMed
3.
go back to reference Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C: The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int. 2004, 15 (12): 1003-1008. 10.1007/s00198-004-1652-z.CrossRefPubMed Caro JJ, Ishak KJ, Huybrechts KF, Raggio G, Naujoks C: The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos Int. 2004, 15 (12): 1003-1008. 10.1007/s00198-004-1652-z.CrossRefPubMed
4.
go back to reference Cotte FE, Mercier F, De Pouvourville G: Relationship between compliance and persistence with osteoporosis medications and fracture risk in primary health care in France: a retrospective case-control analysis. Clinical therapeutics. 2008, 30 (12): 2410-2422. 10.1016/j.clinthera.2008.12.019.CrossRefPubMed Cotte FE, Mercier F, De Pouvourville G: Relationship between compliance and persistence with osteoporosis medications and fracture risk in primary health care in France: a retrospective case-control analysis. Clinical therapeutics. 2008, 30 (12): 2410-2422. 10.1016/j.clinthera.2008.12.019.CrossRefPubMed
5.
go back to reference Cortet B, Benichou O: Adherence, persistence, concordance: do we provide optimal management to our patients with osteoporosis?. Joint Bone Spine. 2006, 73 (5): e1-7. 10.1016/j.jbspin.2006.02.006.CrossRefPubMed Cortet B, Benichou O: Adherence, persistence, concordance: do we provide optimal management to our patients with osteoporosis?. Joint Bone Spine. 2006, 73 (5): e1-7. 10.1016/j.jbspin.2006.02.006.CrossRefPubMed
6.
go back to reference Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986, 24 (1): 67-74. 10.1097/00005650-198601000-00007.CrossRefPubMed Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986, 24 (1): 67-74. 10.1097/00005650-198601000-00007.CrossRefPubMed
7.
go back to reference Sprangers MA, Aaronson NK: The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: a review. Journal of clinical epidemiology. 1992, 45 (7): 743-760. 10.1016/0895-4356(92)90052-O.CrossRefPubMed Sprangers MA, Aaronson NK: The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease: a review. Journal of clinical epidemiology. 1992, 45 (7): 743-760. 10.1016/0895-4356(92)90052-O.CrossRefPubMed
8.
go back to reference Macquart-Moulin G, Viens P, Bouscary ML, Genre D, Resbeut M, Gravis G, Camerlo J, Maraninchi D, Moatti JP: Discordance between physicians' estimations and breast cancer patients' self-assessment of side-effects of chemotherapy: an issue for quality of care. British journal of cancer. 1997, 76 (12): 1640-1645.CrossRefPubMedPubMedCentral Macquart-Moulin G, Viens P, Bouscary ML, Genre D, Resbeut M, Gravis G, Camerlo J, Maraninchi D, Moatti JP: Discordance between physicians' estimations and breast cancer patients' self-assessment of side-effects of chemotherapy: an issue for quality of care. British journal of cancer. 1997, 76 (12): 1640-1645.CrossRefPubMedPubMedCentral
9.
go back to reference Hidding A, van Santen M, De Klerk E, Gielen X, Boers M, Geenen R, Vlaeyen J, Kester A, van der Linden S: Comparison between self-report measures and clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis and fibromyalgia. The Journal of rheumatology. 1994, 21 (5): 818-823.PubMed Hidding A, van Santen M, De Klerk E, Gielen X, Boers M, Geenen R, Vlaeyen J, Kester A, van der Linden S: Comparison between self-report measures and clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis and fibromyalgia. The Journal of rheumatology. 1994, 21 (5): 818-823.PubMed
10.
go back to reference Byerly MJ, Thompson A, Carmody T, Bugno R, Erwin T, Kashner M, Rush AJ: Validity of electronically monitored medication adherence and conventional adherence measures in schizophrenia. Psychiatric services (Washington, DC). 2007, 58 (6): 844-847.CrossRef Byerly MJ, Thompson A, Carmody T, Bugno R, Erwin T, Kashner M, Rush AJ: Validity of electronically monitored medication adherence and conventional adherence measures in schizophrenia. Psychiatric services (Washington, DC). 2007, 58 (6): 844-847.CrossRef
11.
go back to reference Velligan DI, Wang M, Diamond P, Glahn DC, Castillo D, Bendle S, Lam YW, Ereshefsky L, Miller AL: Relationships among subjective and objective measures of adherence to oral antipsychotic medications. Psychiatric services (Washington, DC). 2007, 58 (9): 1187-1192.CrossRef Velligan DI, Wang M, Diamond P, Glahn DC, Castillo D, Bendle S, Lam YW, Ereshefsky L, Miller AL: Relationships among subjective and objective measures of adherence to oral antipsychotic medications. Psychiatric services (Washington, DC). 2007, 58 (9): 1187-1192.CrossRef
12.
go back to reference Murri R, Ammassari A, Trotta MP, De Luca A, Melzi S, Minardi C, Zaccarelli M, Rellecati P, Santopadre P, Soscia F, et al: Patient-reported and physician-estimated adherence to HAART: social and clinic center-related factors are associated with discordance. Journal of general internal medicine. 2004, 19 (11): 1104-1110. 10.1111/j.1525-1497.2004.30248.x.CrossRefPubMedPubMedCentral Murri R, Ammassari A, Trotta MP, De Luca A, Melzi S, Minardi C, Zaccarelli M, Rellecati P, Santopadre P, Soscia F, et al: Patient-reported and physician-estimated adherence to HAART: social and clinic center-related factors are associated with discordance. Journal of general internal medicine. 2004, 19 (11): 1104-1110. 10.1111/j.1525-1497.2004.30248.x.CrossRefPubMedPubMedCentral
13.
go back to reference Cramer JA, Amonkar MM, Hebborn A, Altman R: Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin. 2005, 21 (9): 1453-1460. 10.1185/030079905X61875.CrossRefPubMed Cramer JA, Amonkar MM, Hebborn A, Altman R: Compliance and persistence with bisphosphonate dosing regimens among women with postmenopausal osteoporosis. Curr Med Res Opin. 2005, 21 (9): 1453-1460. 10.1185/030079905X61875.CrossRefPubMed
14.
go back to reference Cramer JA, Lynch NO, Gaudin AF, Walker M, Cowell W: The effect of dosing frequency on compliance and persistence with bisphosphonate therapy in postmenopausal women: a comparison of studies in the United States, the United Kingdom, and France. Clin Ther. 2006, 28 (10): 1686-1694. 10.1016/j.clinthera.2006.10.013.CrossRefPubMed Cramer JA, Lynch NO, Gaudin AF, Walker M, Cowell W: The effect of dosing frequency on compliance and persistence with bisphosphonate therapy in postmenopausal women: a comparison of studies in the United States, the United Kingdom, and France. Clin Ther. 2006, 28 (10): 1686-1694. 10.1016/j.clinthera.2006.10.013.CrossRefPubMed
15.
go back to reference Recker RR, Gallagher R, MacCosbe PE: Effect of dosing frequency on bisphosphonate medication adherence in a large longitudinal cohort of women. Mayo Clin Proc. 2005, 80 (7): 856-861. 10.4065/80.7.856.CrossRefPubMed Recker RR, Gallagher R, MacCosbe PE: Effect of dosing frequency on bisphosphonate medication adherence in a large longitudinal cohort of women. Mayo Clin Proc. 2005, 80 (7): 856-861. 10.4065/80.7.856.CrossRefPubMed
16.
go back to reference Cote I, Farris K, Feeny D: Is adherence to drug treatment correlated with health-related quality of life?. Qual Life Res. 2003, 12 (6): 621-633. 10.1023/A:1025180524614.CrossRefPubMed Cote I, Farris K, Feeny D: Is adherence to drug treatment correlated with health-related quality of life?. Qual Life Res. 2003, 12 (6): 621-633. 10.1023/A:1025180524614.CrossRefPubMed
17.
go back to reference Hadji P, Minne H, Pfeifer M, Bourgeois P, Fardellone P, Licata A, Devas V, Masanauskaite D, Barrett-Connor E: Treatment preference for monthly oral ibandronate and weekly oral alendronate in women with postmenopausal osteoporosis: A randomized, crossover study (BALTO II). Joint Bone Spine. 2008, 75 (3): 303-310. 10.1016/j.jbspin.2007.07.011.CrossRefPubMed Hadji P, Minne H, Pfeifer M, Bourgeois P, Fardellone P, Licata A, Devas V, Masanauskaite D, Barrett-Connor E: Treatment preference for monthly oral ibandronate and weekly oral alendronate in women with postmenopausal osteoporosis: A randomized, crossover study (BALTO II). Joint Bone Spine. 2008, 75 (3): 303-310. 10.1016/j.jbspin.2007.07.011.CrossRefPubMed
18.
go back to reference Giangregorio L, Papaioannou A, Thabane L, DeBeer J, Cranney A, Dolovich L, Adili A, Adachi JD: Do patients perceive a link between a fragility fracture and osteoporosis?. BMC musculoskeletal disorders. 2008, 9: 38-10.1186/1471-2474-9-38.CrossRefPubMedPubMedCentral Giangregorio L, Papaioannou A, Thabane L, DeBeer J, Cranney A, Dolovich L, Adili A, Adachi JD: Do patients perceive a link between a fragility fracture and osteoporosis?. BMC musculoskeletal disorders. 2008, 9: 38-10.1186/1471-2474-9-38.CrossRefPubMedPubMedCentral
19.
go back to reference Lau E, Papaioannou A, Dolovich L, Adachi J, Sawka AM, Burns S, Nair K, Pathak A: Patients' adherence to osteoporosis therapy: exploring the perceptions of postmenopausal women. Canadian family physician Medecin de famille canadien. 2008, 54 (3): 394-402.PubMed Lau E, Papaioannou A, Dolovich L, Adachi J, Sawka AM, Burns S, Nair K, Pathak A: Patients' adherence to osteoporosis therapy: exploring the perceptions of postmenopausal women. Canadian family physician Medecin de famille canadien. 2008, 54 (3): 394-402.PubMed
20.
go back to reference Donovan JL, Blake DR: Patient non-compliance: deviance or reasoned decision-making?. Social science & medicine (1982). 1992, 34 (5): 507-513.CrossRef Donovan JL, Blake DR: Patient non-compliance: deviance or reasoned decision-making?. Social science & medicine (1982). 1992, 34 (5): 507-513.CrossRef
21.
go back to reference Veg A, Rosenqvist U, Sarkadi A: Self-management profiles and metabolic outcomes in type 2 diabetes. Journal of advanced nursing. 2006, 56 (1): 44-54. 10.1111/j.1365-2648.2006.03978.x.CrossRefPubMed Veg A, Rosenqvist U, Sarkadi A: Self-management profiles and metabolic outcomes in type 2 diabetes. Journal of advanced nursing. 2006, 56 (1): 44-54. 10.1111/j.1365-2648.2006.03978.x.CrossRefPubMed
22.
go back to reference Veazie PJ, Cai S: A connection between medication adherence, patient sense of uniqueness, and the personalization of information. Medical hypotheses. 2007, 68 (2): 335-342. 10.1016/j.mehy.2006.04.077.CrossRefPubMed Veazie PJ, Cai S: A connection between medication adherence, patient sense of uniqueness, and the personalization of information. Medical hypotheses. 2007, 68 (2): 335-342. 10.1016/j.mehy.2006.04.077.CrossRefPubMed
23.
go back to reference Horne R, Weinman J: Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of psychosomatic research. 1999, 47 (6): 555-567. 10.1016/S0022-3999(99)00057-4.CrossRefPubMed Horne R, Weinman J: Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of psychosomatic research. 1999, 47 (6): 555-567. 10.1016/S0022-3999(99)00057-4.CrossRefPubMed
24.
go back to reference Gossec L, Tubach F, Dougados M, Ravaud P: Reporting of adherence to medication in recent randomized controlled trials of 6 chronic diseases: a systematic literature review. Am J Med Sci. 2007, 334 (4): 248-254. 10.1097/MAJ.0b013e318068dde8.CrossRefPubMed Gossec L, Tubach F, Dougados M, Ravaud P: Reporting of adherence to medication in recent randomized controlled trials of 6 chronic diseases: a systematic literature review. Am J Med Sci. 2007, 334 (4): 248-254. 10.1097/MAJ.0b013e318068dde8.CrossRefPubMed
25.
go back to reference Cotté FE, Fardellone P, Mercier F, Gaudin AF, Roux C: Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis. Osteoporos Int. 2010, 21 (1): 145-155.CrossRefPubMed Cotté FE, Fardellone P, Mercier F, Gaudin AF, Roux C: Adherence to monthly and weekly oral bisphosphonates in women with osteoporosis. Osteoporos Int. 2010, 21 (1): 145-155.CrossRefPubMed
Metadata
Title
Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment
Authors
Dominique Huas
Françoise Debiais
Francis Blotman
Bernard Cortet
Florence Mercier
Chantal Rousseaux
Véronique Berger
Anne-Françoise Gaudin
François-Emery Cotté
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2010
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/1472-6874-10-26

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