Sustainability And Compliance Studies In Patients With Osteoporosis Using Bisphosphonates

ObjectiveAccording to the investigation of outpatient prescription status of the use of bisphosphonates patients’persistence and compliance of China-Japan Friendship Hospital in 2014, we try to find out the impact of medication compliance in patients with osteoporosis.MethodsTook out all the bisphosphonates (including oral and intravenous formulations) prescription from January 1,2014 to December 31 in China-Japan Friendship Hospital for clues, exclued those patients with hypercalcemia, tumors, bone metastases, Paget disease, osteogenesis imperfecta. Telephoned and surveyed those patients with the diagnosis of osteoporosis, to find out the practical application and compliance of the drug, the cognition on bisphosphonates significance and the knowledge about course of therapy. The results were obtained by bisphosphonate prescriptions of 10364, excluding the same patients with multiple prescriptions and prescription indications for non osteoporosis. There were 2732 prescriptions meeting the standard. Of which 402 cases of the patients with no telephone number,742 cases went no answer for three times or error number,121 cases didn’t cooperate,61 people did not know the medication,11 patients had died, at last 1395 cases had a satisfactory interview information. Defining patients who took oral bisphosphonates correctly and the medication compliance was greater than 80% for good compliance and persistence, those continuous medication time was less than half a year for poor compliance and persistence. Using SPSS20.0 to analyze the results, count data between groups were compared with x2 test and the measurement data were compared with T test, related factors by logistic regression analysis.Results1. In the 1395 cases who accepted the telephone interviews,1193 cases took oral bisphosphonates (1060 cases took alendronate sodium tablets(76.0%),133 cases took risedronic acid sodium tablets(9.5%)),202 cases used intravenous bisphosphonates (zoledronic acid injection 5mg/year(14.5%)).2. In the investment of drug compliance,41.67% patients took the oral bisphosphonates regularly currently and correctly,24.42% patients took no more than half a year and didn’t take any more, suggesting that the medication persistence of oral bisphosphonates needed to be improved. Patients with oral bisphosphonates knew or had been completed at least 3 years of treatment accounted for 25.98%, those who didn’t know the course of the bisphosphonate treatment accounted for 74.01%.3.43.14% patients in the prescription of zoledronic acid injection knew the drug course was 3 years, only 29.90% knew the drug course and were willing to finish it, but after confirming its course,73.08% would like to complete the course of at least 3 years injection.4. Multi factor analysis showed that the patient’s cognition of the medication, the number of the combined diseases, the level of the main prescription doctor and use glucocorticoid or not were the important factors influencing the persistence of long-term use of the oral bisphosphonates. After informing the necessary of long-term use of the bisphosphonates, 66.92% patients were willing to accept the treatment, the main reason of those who still did not accept for the long-term treatment was they worried about the side effects of the drug, also medication trouble and patinets couldn’t adhere to take medicine regularly also accounted for a certain proportion, only 3.44% patients refused to accept long-term treatment because of costs.ConclusionIn the upper first-class general hospitals, the ratio of good complications was very low in the osteoporosis patients applicated of bisphosphonates. When the patients knew the course of the medication, with fewer combined diseases, higher level of the main prescription doctors, used glucocorticoid, they would have better persistence. After a brief inform about the necessary of the long-term use of bisphosphonates, more patients accepted the therapy, but there were still a considerable proportion of patients were reluctant to accept long-term treatment because of concerning about drug side effects. Therefore, it is necessary to strengthen the education of knowledge about long-term bisphosphonate therapy on patients in the clinical, in order to improve the curative effect of bisphosphonates.