Analysis of adherence to treatment of patients with osteoporosis in the Omsk region (based on materials from the regional Center for the prevention and treatment of osteoporosis

Background. Non-adherence to treatment, especially in chronic conditions, is a significant problem facing clinical medicine. Failure to adhere to treatment recommendations is often noted in the treatment of osteoporosis, which reduces the effectiveness of anti-osteoporotic drugs and a set of measures to prevent the occurrence of osteoporotic fractures.

Aim. The aim of the study was to assess the adherence of patients of the Center for the Prevention and Treatment of Osteoporosis to treatment with anti-osteoporotic drugs of pathogenetic action.

Materials and methods. This continuous observational study analyzed the adherence to long-term anti-osteoporotic therapy of patients observed at the Center for the Prevention and Treatment of Osteoporosis, the reasons for discontinuing treatment, doctors’ preferences in prescribing anti-osteoporotic therapy, reasons for changing the anti-osteoporotic drug. The study period is from July to December 2019.

Results. During the analyzed period, 625 patients turned to the Center for the Prevention and Treatment of Osteoporosis. The preferences of doctors when prescribing anti-osteoporotic therapy have changed: the proportion of prescriptions for zoledronic acid and denosumab increased, mainly due to a reduction in the prescriptions of strontium ranelate, as well as risendronic acid, teriparatide, and calcitonin was no longer prescribed. Among 370 patients who received a therapeutic appointment (with an already known outcome of a therapeutic appointment), 40.0 ± 2.5% were non-compliant. Including: 9.7 ± 1.5% did not start taking the drug, interrupted the course ahead of schedule — 28.7 ± 2.4%. The termination of the course of therapy in 57.7% of cases was unauthorized, in another 42.3% it was associated with side effects. Patients started and continued further therapy with the initially prescribed drug in 53.8% of cases. As expected, the best adherence rates were found for drugs with parenteral administration once a year (zoledronic acid).

Conclusions. Comparative analysis of the prescriptions of the main drugs of the pathogenetic action of patients of the center for the prevention and treatment of osteoporosis showed low compliance.

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