A hospital pharmacist led assessment of the persistence to bisphosphonates, vitamin D and calcium supplements in postmenopausal women with osteoporosis

摘要

Objectives: To assess and compare the point prevalence of postmenopausal women with osteoporosis persistent to bisphosphonates, vitamin D and calcium supplements between those who have already been provided with multidisciplinary care at specialist orthopaedic hospital and those treated at the primary care level. Methods: A hospital pharmacist-led descriptive cross-sectional study based on a structured questionnaire and available medical records was conducted prospectively among postmenopausal women with osteoporosis already treated and newly admitted as outpatients at a specialist orthopaedic hospital between January and June 2014. Results: From the 385 postmenopausal women who had osteoporosis confirmed and were included in the study, 75 (27.1%) and 83 (76.9%) did not use bisphosphonates while treated at the specialist orthopaedic hospital and at primary care, respectively. There were significantly more study participants persistent to bisphosphonates longer than 12 months among postmenopausal women that have been already provided with health care at specialist orthopaedic hospital (46%) compared to those newly admitted (13.9%) (p <0.01). Persistence to vitamin D and calcium supplements followed the same pattern. No difference was observed in treatment persistence when postmenopausal women were categorised on the basis of experienced fracture in both study groups. The number of postmenopausal women persistent with antiresorptive treatment longer than 12 months decreased significantly with time they spent registered at the specialist orthopaedic hospital (p <0.05). Conclusion: This study showed that regardless of whether postmenopausal 'women with osteoporosis were provided health care services at primary care or specialist orthopaedic hospital, there is still a high percentage of them not taking antiresorptive therapy at all. Among those patients on therapy, persistence with treatment is decreasing with time, which poses a risk for fractures and represents a significant concern for health care professionals.