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 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 supplementation 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. i 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. i 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. i 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 recognise 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."
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
Fardellone P, et al. A new combination packaging for osteoporosis treatment; patient preference and expected adherence to the therapy. Calcified Tissue International, 2007;80(supp 1):s143 (P332-T)
Osteoporosis supplement co-prescribing versus recommendation compliance study. IPSOS Suisse. December 2007. P&G data on file
Melton LJ, et al. Perspective. How many women have osteoporosis? J Bone Miner Res 1992; 7: 1005-1010
International Osteoporosis Foundation. Facts and statistics about osteoporosis and its impact. www.osteofound.org/press_centre/fact_sheet.html
Cooper C, Atkinson EJ, Jacobsen SJ, et al. Population-based study of survival after osteoporotic fractures. Am J Epidemiol 1993; 137:1001-1005
Leibson CL, Tosteson AN, Gabriel SE, et al. Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc 2002; 50: 1644-1650
Magaziner J, Simonsick EM, Kashner TM, et al. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol 1990; 45: M101-M107
Explore further: Bacteria blamed in indigenous Mexican baby deaths