Rheumatology Department, University Hospital of Saint Etienne, 42055, Saint-Etienne Cedex 2, France.
Osteoporos Int. 2011 Jul;22(7):2099-106. doi: 10.1007/s00198-011-1638-6. Epub 2011 Apr 29.
Adherence to osteoporosis treatment is not satisfactory. Our study evaluated persistence and compliance with these treatments prescribed specifically in the context of a fracture liaison service (FLS), an internal health care network, and showed that this type of organization in our institution was associated with high level of adherence.
Medical management of patients with a fragility fracture has been improved by health care internal network or FLS organized in large hospitals. However, treatment effectiveness is not only related to larger initiation rate but also to better long-term adherence. Therefore, we evaluated persistence and compliance in the context of osteoporosis treatment initiated in our institution's FLS, among postmenopausal women with a peripheral fragility fracture.
Patients with a specific osteoporosis treatment prescribed while visiting our FLS were contacted by phone to answer an evaluation questionnaire. A simplified questionnaire was sent to their general physicians when we were not able to reach patients on the phone.
Of the 279 selected patients, 155 were evaluated. Of them, 90.3% had actually started their treatment and 80% were still under treatment after 1 year. After 27.4 ± 11.7 months of follow-up, 67.7% of patients were persistent with their treatment. In addition, 87% of the persistent patients declared to respect both treatment posology and administration conditions. Occurrence of adverse events was the first cause of treatment interruption within the first 6 months.
Our data showed a high level of persistence with osteoporosis treatment when initiation was performed in an FLS, even on a long-term basis. Since follow-up and renewal of treatment were under routine daily practise, our study underlines how important the first prescription conditions are and provides additional interest in medical care network such as FLS.
骨质疏松症治疗的依从性并不令人满意。我们的研究评估了在骨折联络服务（FLS）背景下专门规定的这些治疗的持续性和依从性，并表明我们机构中这种类型的组织与高水平的依从性相关。
在大型医院组织的内部医疗保健网络或 FLS 改善了脆性骨折患者的医疗管理。然而，治疗效果不仅与更高的起始率有关，而且与更好的长期依从性有关。因此，我们评估了在我们机构的 FLS 启动的骨质疏松症治疗背景下，绝经后患有外周脆性骨折的女性的持续性和依从性。
通过电话联系在我们的 FLS 就诊时接受特定骨质疏松症治疗的患者，以回答评估问卷。当我们无法通过电话联系到患者时，会向他们的全科医生发送简化的问卷。
在 279 名选定的患者中，有 155 名进行了评估。其中，90.3%的患者实际开始了治疗，80%的患者在 1 年后仍在接受治疗。在 27.4±11.7 个月的随访后，67.7%的患者持续接受治疗。此外，87%的持续治疗患者声明他们遵守了治疗方案和给药条件。在最初的 6 个月内，不良事件的发生是治疗中断的首要原因。
我们的数据表明，在 FLS 中启动治疗时，即使在长期基础上，骨质疏松症治疗的持续性也很高。由于随访和治疗的更新是在常规日常实践中进行的，因此我们的研究强调了首次处方条件的重要性，并为医疗保健网络（如 FLS）提供了更多的关注。
