IMPACT OF THE TRAINING ON THE COMPLIANCE AND PERSISTENCE OF WEEKLY BISPHOSPHONATE TREATMENT IN POSTMENOPAUSAL OSTEOPOROSIS: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

TÃœZÃœN S.¹, AKYÃœZ G.², ESKIYURT N.³, MEMIÅž A.⁴, KURAN B.⁵, İÇAÄžASIOÄžLU A.⁶, SARPEL T.⁷, ÖZDEMIR F.⁸, ÖZGIRGIN N.⁹, GÃœNAYDIN R.¹⁰, ÇAKÇI A.¹¹, YURTKURAN M.^12
1Department of Physical Medicine and Rehabilitation, Istanbul University, Cerrahpasa School of Medicine, Istanbul.
²Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul.
³Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul School of Medicine, Istanbul.
⁴Physical Medicine and Rehabilitation Clinic, Izmir Ataturk Training and Research Hospital, Izmir.
⁵Physical Medicine and Rehabilitation Clinic, Sisli Etfal Training and Research Hospital, Istanbul.
⁶Physical Medicine and Rehabilitation Clinic, Goztepe Training and Research Hospital, Istanbul.
⁷Department of Physical Medicine and Rehabilitation, Cukurova University Faculty of Medicine, Adana.
⁸Department of Physical Medicine and Rehabilitation, Trakya University Faculty of Medicine, Edirne.
⁹Physical Medicine and Rehabilitation Clinic, Ankara Physical Therapy Training and Research Hospital, Ankara.
¹⁰Physical Medicine and Rehabilitation Clinic, Izmir Training and Research Hospital, Ä°zmir.
¹¹Physical Medicine and Rehabilitation Clinic, Diskapi Training and Research Hospital, Ankara.
¹²Department of Physical Medicine and Rehabilitation, Uludag University Faculty of Medicine, Bursa, Turkey.

Received : 12-07-2012     Accepted : 04-07-2013     Published : 06-08-2013
Volume : 1     Issue : 1       Pages : 1 - 6
World Res J Med Sci 1.1 (2013):1-6

Long-term patient adherence to osteoporosis treatment is poor despite proven efficacy. In this study, we aimed to assess the impact of active patient training on treatment compliance and persistence in patients with postmenopausal osteoporosis. This was a national, multicenter, observational cohort study. Women with postmenopausal osteoporosis (45-75 years) started on weekly bisphosphonate treatment were randomized to active training (AT) and passive training (PT) groups and followed for 12 months. PT group received a bisphosphonate usage guide and osteoporosis training booklets. Additionally, AT group received four phone calls (months 2, 5, 8, 11) and participated in four interactive/educational meetings held in groups of 10 patients (months 3, 6, 9, 12). Three-monthly follow-up visits were scheduled for all. Primary evaluation criteria were self-reported persistence and compliance to treatment. In total 226 and 222 patients were randomized into AT and PT groups (mean age 62.4±7.7 years), respectively. At 12 months, persistence was 67% in both groups. Compliance in terms of dosage timing was 46% and 44% in AT and PT groups, respectively and compliance in terms of number of dosages was 61% and 59% (p>0.05 for both measures). On surveys most persistent patients gave high scores for efficacy, safety and tolerability of their treatment. The majority of persistent patients wished to continue treatment after 12 months. QUALEFFO scores improved similarly in both groups. In conclusion, active patient training beyond passive patient training provided at the first visit did not improve persistence and compliance for bisphosphonate treatment. Providing positive feedback at frequent follow-up visits and less frequent dosing options may further improve patient adherence.