Department of Endocrine Disoders and Bone Metabolism, 1st Chair of Endocrinology, Medical University, Łódz, Poland.
Endokrynol Pol. 2011 Jan-Feb;62(1):24-9.
More than half of those with chronic diseases, including osteoporosis, discontinue treatment during the first year of its administration. This problem increases over the course of continued follow-up. Additionally, it has been observed that 13% of women, prescribed oral daily alendronate, do not even start the treatment, while 20% of patients discontinue the therapy during the first four months. On the other hand, those patients who are compliant achieve increased bone mass density with a simultaneous decrease of fracture risk. The aim of our study was to assess the adherence to the recommended alendronate 70 administration protocol over the course of 12 months by women with post-menopausal osteoporosis.
Adherence (compliance plus persistence) to alendronate 70 therapy was assessed in a prospective study of 153 post-menopausal women, followed up for one year with monitoring every two months.
Adherence to therapy of all the study participants was high during the entire study period, the patients remaining compliant after a year in 95.08 ± 1.39% (mean ± SEM) of cases, and the mean persistence with medication was 347.05 ± 5.07 days. In the group of patients who interrupted treatment, the mean persistence was 212.44 days. One of the study participants did not start the treatment, and another two discontinued the therapy within 30-60 days of the study onset (between the first two visits). Facilitated contacts with the doctor, continuous access to prescribed treatment and frequent visits significantly improved patient compliance. The common reason for discontinuation was side effects, while age (but not education) affected the rate of compliance with therapy. The worst results were obtained in the group of patients with osteoporosis diagnosed more than five years before the study, particularly in the subgroup where alendronate was being used for the first time or where treatment resumed after a substantial break.
The obtained results indicate that better adherence to alendronate 70 therapy, administered once a week, depends on more frequent monitoring of treated patients.
超过一半患有慢性病（包括骨质疏松症）的患者，在药物治疗的第一年就会中断治疗。这种情况在持续随访过程中会加剧。此外，研究观察到，13%接受口服阿仑膦酸钠（alendronate）每日治疗的女性甚至没有开始治疗，而 20%的患者在头四个月就停止了治疗。另一方面，那些依从性好的患者，其骨密度增加，骨折风险降低。我们的研究目的是评估 153 名绝经后骨质疏松症女性在 12 个月的时间里，对推荐剂量的阿仑膦酸钠（alendronate）70 治疗方案的依从性。
采用前瞻性研究，对 153 名绝经后骨质疏松症女性进行随访 1 年，每两个月监测一次，评估阿仑膦酸钠 70 治疗的依从性（包括遵嘱服药和持续用药）。
在整个研究期间，所有研究参与者的治疗依从性都很高，一年后仍有 95.08±1.39%（平均值±标准误）的患者依从治疗，平均用药持续时间为 347.05±5.07 天。在中断治疗的患者中，平均用药持续时间为 212.44 天。有 1 名患者未开始治疗，另有 2 名患者在研究开始后 30-60 天内（在头两次就诊期间）停止了治疗。与医生保持方便的联系、持续获得处方治疗和频繁就诊显著提高了患者的依从性。停药的常见原因是副作用，而年龄（而非教育程度）影响了治疗的依从率。在研究前五年以上被诊断为骨质疏松症的患者组中，结果最差，尤其是在首次使用阿仑膦酸钠或在中断治疗后重新开始治疗的亚组中。
研究结果表明，每周一次给予阿仑膦酸钠 70 治疗，更好的依从性取决于更频繁地监测治疗患者。
