title: Determinant factors of osteoporosis patients' reported therapeutic adherence to calcium and/or vitamin D supplements: a cross-sectional, observational study of postmenopausal women.
abstract: BACKGROUND
  Among the various treatments for osteoporosis, calcium and/or vitamin D supplements are frequently included.
  
  
  OBJECTIVE
  The objective of the study was to analyse adherence to calcium and/or vitamin D treatment and to identify related predictors of non-adherence in a sample of postmenopausal women treated for osteoporosis in primary care.
  
  
  METHODS
  A cross-sectional, observational study was conducted in a sample of postmenopausal women receiving pharmaceutical treatment for osteoporosis with vitamin D and/or calcium. Sociodemographic, general and osteoporosis-related data were collected. Patient's perceptions of the adverse effects of treatment, their knowledge of osteoporosis (Batalla test), their attitude towards treatment (Morisky-Green test) and their self-reported therapeutic adherence (Haynes-Sackett test) were assessed.
  
  
  RESULTS
  Of 630 women (mean age +/- SD 64.1 +/- 8.7 years) evaluated, 36.2% (95% CI 32.4, 39.9) had problems with treatment tolerability, 63.5% (95% CI 59.7, 67.3) had good knowledge of osteoporosis, 20.5% (95% CI 17.3, 23.6) had a good attitude to treatment and 50.0% (95% CI 46.1, 53.9) had good self-reported adherence to treatment. Patients in the poor adherence group had higher mean body mass index (p = 0.014), more concurrent pathologies (p = 0.003), more tolerability problems (p < 0.001) and worse attitude to treatment (p < 0.001). The multivariate model showed a positive relationship between therapeutic adherence and good attitude to treatment (odds ratio [OR] = 11.7; p < 0.001), not having tolerability problems (OR = 3.3; p < 0.001) and no polymedication (OR = 0.80; p = 0.017).
  
  
  CONCLUSIONS
  Only one in two postmenopausal women with osteoporosis who take calcium and/or vitamin D have good self-reported therapeutic adherence to this treatment. Determinant factors of adherence to calcium and/or vitamin D treatment were patient's attitude to the treatment, tolerability problems with the treatment and number of concurrent treatments.
authors.affiliation: Nazaret's Health Centre, Department 5 CV, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Sanfelix-Genovés
authors.forename: Vicente F
authors.initials: VF
authors.lastname: Gil-Guillén
authors.forename: Domingo
authors.initials: D
authors.lastname: Orozco-Beltran
authors.forename: Vicente
authors.initials: V
authors.lastname: Giner-Ruiz
authors.forename: Salvador
authors.initials: S
authors.lastname: Pertusa-Martínez
authors.forename: Begoña
authors.initials: B
authors.lastname: Reig-Moya
authors.forename: Concepción
authors.initials: C
authors.lastname: Carratalá
mesh_terms: D000704:Analysis of Variance; D002118:Calcium / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008875:Middle Aged; D019370:Observation; D015663:Osteoporosis, Postmenopausal / Q000178:diet therapy*; D011320:Primary Health Care / Q000706:statistics & numerical data; D014807:Vitamin D / Q000627:therapeutic use*; D016903:Drug Monitoring
chemical_list: D014807:Vitamin D; D002118:Calcium