Self-reported compliance with osteoporosis medication-qualitative aspects and correlates

The analysis aims to assess (1) compliance with anti-osteoporosis pharmacotherapy and (2) the prevalence of calcium and vitamin D co-medication among Czech women in common clinical practice.

A cross-sectional multicentre questionnaire survey was performed in consecutive secondary care female patients aged > or =40 years. Three main dimensions of compliance were studied: drug compliance (based on missed doses over the last month), co-medication with calcium/vitamin D and compliance with dosing instructions for safe and effective use of bisphosphonates (BIS).

The therapy in 200 osteoporosis patients was alendronate (44.5%), risedronate (24.5%), raloxifene (18%) and calcitonin (13%). The three dimensions of compliance were not associated with each other. None of the compliance-related outcomes correlated with the osteoporosis knowledge score obtained in the Osteoporosis Questionnaire (OPQ) of Pande et al. The most frequently reported reason for non-compliance was "drug not handy". Similar mean compliance rates were achieved with once daily and once weekly BIS. The rates of current calcium and vitamin D co-medication were 73% and 62%, respectively. Calcium co-medication was associated with obtaining information on medications against osteoporosis from other sources besides health care professionals (P = 0.038). Compliance with dosing instructions correlated negatively with age (P = 0.001).

Compliance with osteoporosis medication in Czech women is suboptimal, in particular the prevalence of co-medication with calcium/vitamin D should be higher. It is needed to implement strategies focused on the patient's beliefs about the disease and perceptions of outcome rather than those promoting the knowledge alone.