Study of Osteoporosis in Portuguese Women aged more than 50 years: Analysis of risk factors and adherence to therapeutic
Keywords:
Osteoporosis, Risk factors, Diagnosis, TreatmentAbstract
Introduction: Osteoporosis is a disease characterized by low bone mass, increased bone fragility and risk of fracture. In Portugal, osteoporosis affects 500 hundred people. The criteria for initiating pharmacological treatment is based on the bone mineral density test and the assessment of risk factors. Due to the asymptomatic condition of the pathology patients don’t adhere correctly to the medication which contributes to a higher risk of fracture and comorbidities.
Objective: The aim of this study was to identify variables associated with osteoporosis and evaluate the adherence with osteoporosis treatment.
Methods: We conducted a study including 107 women aged over 50 years old. The data was collected by questionnaire and women were examined using Quantitative Ultrasound of the Calcaneus.
Results: 43.9 % of women were normal, 37.4% had osteopenia and 18.7% had osteoporosis. Increased age (p=0.000) and menopause (p=0.013) were correlated with T-score. Body mass index (p=0.380) was not statistically correlated with T-score. Patients taking bisphosphonates, with older age and with treatments longer than 6 months presented poor adherence to medication.
Conclusions: Age, menopause and family history of osteoporosis were risk factors for the disease. Age and the duration of treatment are factors that exacerbate the poor adherence.
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References
Abrahamsen, B., Brask-Lindemann, D., Rubin, K., & Schwarz, P. (2014). A review of lifestyle, smoking and other modifiable risk factors for osteoporotic fractures. Bonekey Report, 574(3), 1-10. doi: 10.1038/bonekey.2014.69.
Associação Nacional Contra a Osteoporose. (2012). Associação nacional contra a osteoporose. Acedido em: http://www.aporos. pt/a-osteoporose.html.
Berry. S., Misra, D., Hannan, M., & Kiel, D. (2010). Low acceptance of treatment in the elderly for the secondary prevention of osteoporotic fracture in the acute rehabilitation setting. Aging Clinical and Experimental Research, 22(3), 231–237. Acedido em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919059/
Chan, D., Chang, C., Lim, L., Brnabic, A., Tsauo, J., Burge R, … Yang, R. (2016). Association between teriparatide treatment persistence and adherence, and fracture incidence in Taiwan: Analysis using the national health insurance research database. Osteoporosis International, 27(9), 2855-2865. doi: 10.1007/s00198-016-3611-x.
Gambacciani, M., & Levancini, M. (2014). Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Przeglad Menopauzalny, 13(4), 213-220. doi: 10.5114/pm.2014.44996.
Huas, D., Debiais, F., Blotman, F., Cortet, B., Mercier, F., Rousseaux, C., … Cotté, F. (2010). Compliance and treatment satisfaction of postmenopausal women treated for osteoporosis: Compliance with osteoporosis treatment. BMC Women’s Health, 10(26), 1-8. doi: 10.1186/1472-6874-10-26.
Kanis, J., McCloskey, E., Johansson, H., Cooper, C., Rizzoli, R., & Reginster, J. (2012). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis International, 24(1), 23-57. doi: 10.1007/s00198-012-2074-y.
Lacombe, J., Cairns, B., Green, J., Reeves, G., Beral, V., & Armstrong, M. (2016). The effects of age, adiposity, and physical activity on the risk of seven site-specific fractures in postmenopausal women. Journal of Bone and Mineral Research, 31(8), 1559-1568. doi: 10.1002/jbmr.2826
Langsetmo, L., Barr, S., Berger, C., Kreiger, N., Rahme, E., Adachi, J., … Goltzman, D. (2014). Associations of protein intake and protein source with mineral density and fracture risk. The Journal of Nutrition Health and Aging, 19(8), 861-868. doi:10.1007/s12603-015-0544-6.
National Osteoporosis Guideline Group. (2014). Osteoporosis clinical guideline for prevention and treatment. University of Sheffield .
Organização Mundial de Saúde. (2011). FRAX: Instrumento de avaliação do risco de fratura da OMS. Acedido em: https://www.shef.ac.uk/FRAX/tool.jsp?lang=pt.
Orimo, H., Nakamura, T., Hosoi, T., Iki, M., Uenishi, K., Endo, N., … Fujiwara S. (2012). Japanese 2011 guidelines for prevention and treatment of osteoporosis: Executive summary. Archives of Osteoporosis, 7(1), 3-20. doi: 10.1007/s11657-012-0109-9
Pavel, O., Popescu, M., Nova, L., Mogoanta, L., Pavel, L., Cicas, R., & Traistaru, M. (2016). Postmenopausal osteoporosis: Clinical, biological and histopathological aspects. Romanian Journal of Morphology and Embryology, 57(1), 121–130.
Pisani, P., Renna, M., Conversano, F., Casciaro, E., Paola, M., Quarta, E., … Casciaro, S. (2016). Major osteoporotic fragility fractures: Risk factor updates and societal impact. World Journal of Orthopedics, 7(3), 171-181. doi: 10.5312/wjo.v7.i3.171.
Portugal, Ministério da Saúde, Direção Geral da Saúde. (2011). Norma nº 027/2011 de 29/11/2011: Tratamento farmacológico da osteoporose pós-menopáusica. Acedido em http://www.dgs.pt/?cr=21174
Portugal, Ministério da Saúde, Direção Geral da Saúde. (2010 ). Norma 001/2010 de 30/9/2010: Prescrição da osteodensitometria na osteoporose do adulto. Acedido em http://www.dgs.pt/ms/8/paginaRegisto.aspx?back=1&id=16678
Rabenda, V., & Reginster, J.(2010). Overcoming problems with adherence to osteoporosis medication. Expert Review of Pharmacoeconomics & Outcomes Research, 10(6), 677– 689. doi: 10.1586/erp.
Rodrigues, A., Laires, P., Gouveia, N., Eusébio, M., Canhão, H., & Branco, J. C. (2015). Characterization of osteoporosis in Portugal: Treatment patterns and reasons for under-treatment and non-persistence with pharmacological treatments. Value Health, 18(7), 1-8.
Ross, S., Samuels, E., Gairy, K., Iqbal, S., Badamgarav, E., & Siris E. (2011). A meta-analysis of osteoporotic fracture risk with medication nonadherence. Value in Health, 14(4). 571-581. doi: 10.1016/j.jval.2010.11.010.
Silva, A., Rosa, M., Fernandes, B., Lumertz, S., Diniz, R., & Damiani, R. (2015). Factors associated with osteopenia and osteoporosis in women undergoing bone mineral density test. Sociedade Brasileira de Reumatologia, 55(3), 223-228. doi: 10.1016/j.rbr.2014.08.012.
Sumit, M., McAlister, F., Johnson, J., Bellerose, D., Siminoski, K., Hanley, D., … Rowe, B. (2012). Interventions to increase osteoporosis treatment in patients with incidentally detected vertebral fractures. The American Journal of Medicine, 125(9), 929-936. doi: 10.1016/j.amjmed.2012.02.021
Tandon, V., Sharma, S., Mahajan, S., Mahajan, A., Khajuria, V., & Gillani, Z. (2016). First Indian prospective randomized comparative study evaluating adherence and compliance of postmenopausal osteoporotic patients for daily alendronate, weekly risedronate and monthly ibandronate regimens of bisphosphonates. Journal of Mid-life Health,5(1), 29-33. doi: 10.4103/0976-7800.127788.
Touskova, T., Vytrisalova, M., Palicka, V., Hendrychova, T., Fuksa, L., Holcova, R., … Kubena, A. (2015). Drug holidays: The most frequent type of noncompliance with calcium plus vitamin D supplementation in persistent patients with osteoporosis. DovePress Journal, 9(1). 1771-1779. doi: 10.2147/PPA.S88630
Warriner A, Curtis J. (2010). Adherence to osteoporosis treatments: Room for improvement. Current Opinion in Rheumatology, 21(4), 356–362. doi: 10.1097/BOR.0b013e32832c6aa4
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