Hints and tips to help patients stay on treatment
1. Identify patients not adhering to osteoporosis treatment through regular communication, clinics and audits.
2. Educate patients to improve understanding of treatment benefits, and illustrate the importance of adhering to treatment long-term.
3. Communicate the importance of adherence by taking account of patients' needs, difficulties and expectations.
4. Focus on behavioural strategies such as constant questioning, incentives, social support and goal-setting to help patients adhere.
5. Consider all available treatment options to ensure patients' needs and preferences are understood and met.
Identify
There are many reasons why osteoporosis patients do not stay on treatment. Those experiencing the following situations may be at an increased risk of not adhering:
• Patients who lead a busy life.
• Patients taking multiple medicines for different diseases at the same time.
• Patients who are treated with medicines that involve complex and frequent dosing schedules.
• Patients who are in denial about their condition.
• Patients who suffer side-effects as a result of their treatment.
Educate
A large number of physicians cite ‘lack of patient understanding’ as the reason for lack of adherence.1 It is thought that one reason why so many women are not staying on treatment is that they do not realise the benefits that their treatment brings. The IOF Adherence Gap survey found 90% of women with osteoporosis viewed it as a serious condition but over two thirds were not aware of the benefits of their treatment, in some cases wrongly believing that there were no benefits at all.1
Educating your patients on why taking a treatment is important will help them stay on therapy and reduce the risk of painful fractures.
Importance of adherence
Communicating the benefits of staying on treatment will help patient understanding. Many patients may feel embarrassed to admit that they are not taking their prescribed treatment as they should do. Showing sincerity, concern and understanding may help the patient feel supported.
It is thought that regular follow-up with patients, better information on treatment options and a more convenient dosing options may help address the issue of poor adherence and help patients and their families living with osteoporosis.
Behavioural strategies
Women are more likely to be influenced to stay on treatment by positive motivating factors. The IOF Adherence Gap survey found over a quarter of patients consider ‘knowing they were doing something to help themselves’ a primary factor in encouraging them to stay on treatment long-term.1
Many IOF member societies run helpful support groups that patients may find beneficial. They provide a forum for patients to share and discuss their own experiences and challenges with taking treatment for their osteoporosis. A list of IOF patient societies can be found here.
Treatment options
There are many different treatments available for osteoporosis, some of which may better suit individual patient needs. Evidence shows that accommodating patients’ preferences and beliefs when selecting treatment improves their adherence levels, and ultimately their treatment outcomes.2 Making patients part of the decision when choosing the most suitable treatment may improve the likelihood of patients staying on treatment.
References
1. IPSOS Health, European Survey of Physicians and Women with Osteoporosis, January – April 2005. Sponsored by Roche/GSK.
2. Unson CG, Siccion E, Gaztambide J, Gaztambide S, Mahoney Trella P and Prestwood K. Non-adherence and osteoporosis treatment preferences of older women: a qualitative study. Journal of Women’s Health 2003; 12 (10): 1037-45
