title: Adherence to Calcium and Vitamin D supplementations: results from the ADVICE Survey.
abstract: OBJECTIVE
  The ADVICE (ADherence in VItamin-D and Calcium Embedded or not) survey was aimed to evaluate the effect of a patient-focused motivation strategy on the adherence to calcium and vitamin D supplementation. The survey also intended to identify possible factors being able to influence the compliance (i.e. the existence of individual preferences towards different dosages or regimens of supplementation).
  
  
  METHODS
  We planned to involve consecutive patients visited between 2010 and 2011 at 35 centres specialized in diagnosis and treatment of osteoporosis in different Italian regions. Each patient has been requested to declare if he/she was already assuming any supplementation with calcium and vitamin D (naïve or not naïve). All patients underwent a first visit (T0) and two follow up visits at 6 and 12 months (T6 e T12). The assessment of the adherence was measured through the Morinsky Medication Adherence Scale, a score based on 8 different questions, specifically validated to determine therapeutical compliance (0-5: not acceptable; 6-7: acceptable; 8: ideal).
  
  
  RESULTS
  732 women (mean age: 66.9; average BMI: 25.3) and 30 men (mean age: 71.9; average BMI: 24.5) were enrolled; 34% of female patients (n=245) and 66% of males (n=20) reported previous fractures. Not naïve patients were 385 (54%). A total of 309 patients (43%) were concurrently assuming an antifracture drug; 229 subjects were osteoporotic (45%), while 224 were osteopenic (44%). The mean Morinsky score in not naïve patients was 5.72, 6.19 and 6.18 at T0, T6, and T12, respectively. Thus, no differences in the Morinsky score were observed between T6 and T12. Naïve patients showed an average Morinsky score of 5.78 at T6 and 6.39 at T12. Older age was not significantly associated with the observed changes in the scores. The onset of AEs related to the supplementation with calcium and vitamin D was able to negatively influence the adherence at the subsequent control point. Bone mineral density, previous fractures, and concurrent assumption of any antifracture drug did not significantly influence the adherence, as well as the differences in the dosages or regimens of calcium and vitamin D administration.
  
  
  CONCLUSIONS
  Activities aimed to strengthen motivation of the patients improved the adherence to calcium and vitamin D supplementations after only 6 months.
authors.affiliation: Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, "AO Sant'Andrea" Hospital, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Conti
authors.forename: Prisco
authors.initials: P
authors.lastname: Piscitelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Italiano
authors.forename: Alessandro
authors.initials: A
authors.lastname: Parma
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Caffetti
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Giolli
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Di Tanna
authors.forename: Andrea
authors.initials: A
authors.lastname: Guazzini
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Brandi
keywords: calcium and vitamin D supplementation; compliance; motivation; preference