title: [Evaluation of adherence to treatment with calcium and vitamin D in the elderly in a basic health area].
abstract: OBJECTIVE
  The vitamin D deficiency is high in the elderly population. Calcium and vitamin D supplements is a frequently used measure in individuals at risk for falls and/or fractures. However, this practice has achieved a low level of compliance. The aim is to assess the adherence to treatment with calcium and vitamin D in elders with hypovitaminosis D in an urban area of Madrid.
  
  
  METHODS
  Intervention study performed on 438 individuals ≥65years from the 'Peñagrande Cohort' with hypovitaminosis D that were treated with calcium and vitamin D. Adherence at 3 and 12 months was assessed using the Morisky-Green and counting of prescriptions written.
  
  
  RESULTS
  A total of 413 of the 438 individuals with hypovitaminosis D were analysed (18 patients were not treated because of contraindications, and 7 were considered lost). At 3 and 12 months, 63.9% and 47.2%, respectively, were adherents. After a brief educational intervention, 19.3% of individuals without adherence at 3 months became good compliers when measured at one year. Comorbidity was associated with lower rates of adherence to treatment after one year (46.3% versus 35.2%, P=.027). The main cause of non-adherence to calcium was digestive intolerance, and due to oversights for vitamin D. Concordance between adherence assessed by the Morisky test and counting of prescriptions written was high (Kappa index=69.8%).
  
  
  CONCLUSIONS
  Non-adherence to chronic treatment with calcium and vitamin D is a relevant problem in elderly. It is important to assess adherence and implement health education strategies in clinical practice.
authors.affiliation: C.S. Fuencarral, Atención Primaria de Madrid, Madrid, España. Electronic address: carmen.mateopascual@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Mateo Pascual
authors.affiliation: C.S. Dr. Castroviejo, Atención Primaria de Madrid, IdiPAZ, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Julián Viñals
authors.affiliation: C.S. Dr. Castroviejo, Atención Primaria de Madrid, IdiPAZ, Madrid, España.
authors.forename: M V
authors.initials: MV
authors.lastname: Castell Alcalá
authors.affiliation: Unidad de Medicina de Familia, Universidad Autónoma de Madrid (UAM), IdiPAZ, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Queipo
authors.affiliation: Departamento Medicina Preventiva, Universidad Autónoma de Madrid (UAM), IdiPAZ, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: Otero Piume
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000627:therapeutic use*; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000188:drug therapy*; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D014807:Vitamin D; D002118:Calcium
keywords: Aged; Anciano; Atención primaria de salud; Calcio; Calcium; Cumplimiento de la medicación; Deficiencia de vitaminaD; Medication adherence; Primary health care; Vitamin D deficiency