Knowledge and Adherence to Alendronate Administration Among Postmenopausal Osteoporosis Patients: A Cross-Sectional...

Background Compliance with alendronate treatment in postmenopausal women is inadequate due to intricate dosing protocols, resulting in diminished therapeutic effectiveness and heightened fracture risk. Although prior research has recorded adherence rates, few have determined independent determinants through multivariate analysis, especially within South Asian communities. This study sought to ascertain adherence rates, identify independent determinants of adherence, evaluate awareness of drug-food combinations, and examine the influence of various counseling sources on compliance. Methods A cross-sectional study was performed at Colombo South Teaching Hospital, Sri Lanka, from January to December 2024, involving 300 postmenopausal women diagnosed with osteoporosis who had been administered alendronate 70 mg weekly for a minimum duration of six months. The sample size was determined with the Lwanga and Lemeshow formula, presuming a 50% adherence rate, a 95% confidence interval, and a 5.7% margin of error. A validated questionnaire evaluated compliance with seven dosing instructions, understanding of 13 drug-food-medication combinations, side effects, and sources of patient education. Multivariate logistic regression discovered independent determinants of optimal adherence. Results The average age was 67.4±8.9 years. Only 48 participants (16.0%) attained optimal adherence (compliance score ≥6/7), with a median compliance score of 4.0 (IQR: 3.0-5.0). In multivariate analysis, the independent predictors of optimal adherence included pharmacist counseling (adjusted OR=3.24, 95% CI: 1.87-5.61, p<0.001), comprehensive understanding of instructions (adjusted OR=2.89, 95% CI: 1.65-5.06, p<0.001), tertiary education (adjusted OR=2.15, 95% CI: 1.23-3.76, p=0.007), and suburban residence (adjusted OR=1.87, 95% CI: 1.12-3.14, p=0.017). The median knowledge score was 6.0 out of 13, with an interquartile range of 5.0 to 7.0. Significant knowledge deficiencies encompassed erroneous notions regarding co-administration with liquids other than plain water (154 participants, 51.3%). Adverse effects were reported by 187 individuals (62.3%), primarily gastrointestinal problems. Conclusions Compliance with alendronate is significantly low among postmenopausal women in Sri Lanka. Pharmacist advice and comprehensive comprehension of instructions were identified as the most significant modifiable determinants of adherence. Healthcare systems must establish organized pharmaceutical care programs and create instructional materials suitable for health literacy to enhance osteoporosis treatment results.