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Many osteoporosis patients not taking calcium, vitamin D

Posted Sep 16 2008 7:11am

New research published today at the annual meeting of the American Society for Bone and Mineral Research (ASBMR), Montréal, Canada, reveals that less than half (43%) of patients in Europe with osteoporosis are claiming to take both calcium and vitamin D supplementation with their osteoporosis treatment. Maximum benefit in managing osteoporosis can be achieved with combination therapy of an osteoporosis treatment (such as a bisphosphonate) with calcium and vitamin D supplementation, yet the majority of patients in this research claim they do not follow this “bone anti-aging” approach.

“Patients with a low intake of calcium and vitamin D may not be receiving the full benefit of their osteoporosis treatment if they do not take enough supplementation”, said Professor Steven Boonen MD, PhD, of Leuven University in Belgium and lead author of the abstract reporting the research results. “It is important that patients not only take both their calcium and vitamin D supplements, but also to ensure that they take them regularly”.

The patient research was conducted amongst 383 women aged 50 years and older who had been diagnosed and treated for post-menopausal osteoporosis in France (n=97), Germany (n=98), Spain (n=94) and the UK (n=94). The aim of the study was to evaluate treatment knowledge and behaviour in women receiving treatment for their osteoporosis with regard to their calcium and vitamin D supplementation.

Patients need help to take calcium and vitamin D supplements regularly

Even when patients do take some form of supplementation, up to 30% claim they regularly miss a dose. An analysis of those patients who declared they were regularly missing a supplement dose revealed this was due either to the fact that they were not convinced of the importance of supplementation, or that they did not receive a detailed explanation from their treating physician. Patient responses also showed that there is a need for some sort of aid, for example, a tool or packaging that would help them take their osteoporosis medication and supplementation. This need for help is supported by patient preference data, which shows that over 70% of patients believe that providing a bisphosphonate with calcium and vitamin D in one box can help them take their supplements regularly and correctly.

Some European countries are performing better than others

The research highlights interesting differences in attitudes to supplementation across the four European countries. These study results showed that Spain generally proved to be a leader in terms of patient behaviour and knowledge about supplementation. For example, when looking at supplement use, 90% of patients in Spain claimed that they were taking some form of supplementation (calcium alone, vitamin D alone or calcium and vitamin D) with their osteoporosis treatment, compared to as few as 61% in the UK and 69% in France. Similarly, patients in Spain claimed to discuss supplementation with their physician more regularly than in other countries - 51% compared to 36% in Germany, 24% in France and 9% in the UK.

Patient trends in the UK highlighted areas for improvement. As well as being the lowest users of supplements and one of the least likely to recognize the importance of calcium and vitamin D supplementation, almost a third of UK patients claimed to have never discussed supplementation with their physician.

When it came to adhering to supplements, women in France appeared to be the most disciplined out of the four countries, with only 13% claiming to regularly miss a dose of any supplement. This was in contrast to the UK, where almost one in three patients reported regularly missing a supplement dose.

“The disparities between countries in attitudes to supplementation may be due to differences in cultures, national health policies or local disease awareness initiatives” said Doctor Patrice Fardellone, of CHU Amiens Hospital in France. “Whilst this research has shown some positive results, there is still room for improvement. It is vital that clinicians continue to educate their patients on the importance of supplements and encourage them to see supplementation as part of complete osteoporosis treatment.”

About osteoporosis

Osteoporosis is a skeletal disease that with aging increases bone fragility and susceptibility to fracture. Fracture is a devastating consequence of osteoporosis and can occur at any site of the body. A 50-year-old woman has around a 40% lifetime risk of suffering a fracture from osteoporosis.

Currently, osteoporosis accounts for 1.6 million hip fractures worldwide per year. Amongst those patients who suffer a hip fracture, approximately one in five will die within the following year, and 40 percent will be unable to walk independently one year later.

Selected references

Boonen S, Fardellone P, Quesada J, et al. OP patients’ behaviours and understanding of the importance of calcium and vitamin D supplementation. ASBMR [abstract] September 2008

Boonen, S et al. The need for clinical guidance in the use of calcium and vitamin D in the management of osteoporosis: a consensus report. Osteoporosis International, 2004; 15:511-519

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