Department of General Practice, UFR Paris 7, Paris, France.
BMC Womens Health. 2010 Aug 20;10:26. doi: 10.1186/1472-6874-10-26.
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.
抗骨质疏松治疗的依从性较差，使接受治疗的女性面临更高的骨折风险。目前对治疗依从性差的决定因素知之甚少。本研究旨在确定医生和患者对骨质疏松症治疗的治疗依从性，并评估影响依从性的因素。
这是一项观察性、横断面的药物流行病学研究，随机选择了 420 名全科医生、154 名风湿病专家和 110 名妇科医生在法国进行研究。研究对象包括患有骨质疏松症且在过去 6 个月内开始治疗的绝经后女性。调查员填写了一份关于临床特征、治疗和病史以及患者依从性的问卷。患者填写了一份关于社会人口特征、生活方式、对骨质疏松症的态度和知识、治疗依从性、治疗满意度和生活质量的问卷。使用 Morisky 药物服用依从量表评估治疗依从性。使用多变量逻辑回归分析评估问卷中收集的变量与依从性的关系。
共评估了 785 名女性。医生认为 95.4%的样本是依从的，但只有 65.5%的女性认为自己是依从的。患者和医生对依从性的看法之间的相关性较低（κ：0.11[95%CI：0.06 至 0.16]）。患者对每月使用双磷酸盐的依从性最高（79.7%），对激素替代治疗的依从性最低（50.0%）。有 6 个变量与依从性相关：治疗管理频率、对长期治疗可接受性的看法、对骨质疏松症健康后果的看法、对骨质疏松症知识的看法、运动和精神生活质量。
抗骨质疏松治疗的依从性较差。减少治疗方案的频率和患者教育可能是提高依从性的有效方法。
