The Compliance Of Alendronate Therapy In Elderly Male Patients With Primary Osteoporosis

Objective To explore the compliance in aged male with primary osteoporosis treatedwith oral alendronate and discuss the relative factors which affect the therapeuticcompliance of drugs. Evaluate the motivational interviewing to improve primaryosteoporosis patients`medication compliance.Method145aged male patients diagnosed with primary osteoporosis who initiated byoral alendronate were enrolled and the medication compliance for one year wasinvestigated. According to the different medication possession ratio (MPR), MPR≥80%was considered adherent and MPR<80%was considered non-adherent. Then comparedthe diversity of two groups and analyzed the related factors which affect the therapeuticcompliance;46patients were recruited who were diagnosed with primary osteoporosis.According to the different clinical time, patients were assigned to control group (CG)and intervention group (IG). Patients in CG were received the basic routine careincluding medication education, a handbook of osteoporosis and a picture album on me--dication usage. Patients in IG were received the same intervention with CG. In additionto this regular intervention IG were also received a10-30min one to one motivationalinterviewing. After12months, data on the patients`confidence, willingness and beliefs of the medication compliance were collected at baseline and after intervention. MPRwere collected at the end of12months. Bone mineral density (BMD) at lumbarspine(L2-L4) and hip were measured at the baseline and at the ending of the interventionindividually. The times of occurrence of fractures within12months were measured. Allthese data were compared between the two groups.Result1.139patients were followed up.32cases (23.02%) were adherent while107cases (76.98%) were non-adherent. The results of Logistic regression analysis to therelated factors which affected therapeutic compliance showed: ostealgia; no-reminder;worried about side-effect; more than7kinds of drugs and uncertain long-dated effect.2.46patients completed date collection at the end of the12months.(1) Compared toCG(n=23), the difference of MPR in IG(n=23)was higher during12month(P<0.05).(2)Compared to CG, the score of confidence, willingness and beliefs in the medicationcompliance of IG after12months were higher (P<0.05).(3) Compared to baseline, thescore of confidence, willingness and beliefs in the medication compliance of IG hadsignificant improvement after12months (P<0.05).(4) Compared to baseline, the scoreof confidence, willingness and beliefs in the medication compliance of CG hadsignificant lower after12months (P<0.05).(5)Compared to CG, Bone mineral density(BMD) at lumbar spine (L2-L4) and hip of IG after12months were higher (P<0.05).(6)Compared to baseline, Bone mineral density (BMD) at lumbar spine (L2-L4) and hip ofIG had significant higher after12months (P<0.05).(7)There was no fractureoccurrence during12months both in two groups.Conclusion Compliance of oral alendronate to treat primary osteoporosis in aged malepatients is poor. Ostealgia can promote the drug compliance, while no-reminder;worried about drug side-effect; more than7kinds of drugs and uncertain long-datedeffect could decrease the drug compliance; It is necessary to have one to onemotivational interviewing among primary osteoporosis patients, which can improvepatients`confidence, willingness and beliefs in the medication compliance, and finallyimprove patients`medication compliance and BMD. It could be used in clinicalpractice.