THE EDUCATIONAL PROGRAM FOR PATIENTS WITH OSTEOPOROSIS AND ITS IMPACT ON ADHERENCE TO TREATMENT: RESULTS OF A MULTICENTER RANDOMIZED TRIAL

Abstract

Introduction: Adherence to treatment in osteoporosis (OP) remains poor. Educating patients is the possible way for improving the situation. Purpose: To evaluate the effect of different forms of educational programs on treatment adherence. Materials and methods: 479 patients (mean age 66.1±7.9 years, 98.1% were women) with osteoporosis from seven centers of Russia were included in the study. The patients were randomly assigned to two groups. Treatment group (241 subjects) was trained at the School of the OP for 4 classes using interactive teaching methods with 7-10 people at a time. Patients of the control group (238 subjects) received information on the OP as a booklet. The number of patients taking calcium and vitamin D, as well as antiosteoporotic medications was not significantly different between groups at baseline. Patients had four centers interim visits at 3 and 6 months. The final visit for all patients was 12 months. Adherence was assessed at 12 months. Results: After the educational program 78.6% of study group and 80.1% of the control group took calcium with vitamin D regularly during 12 months (p>0.05). Antiosteoporotic medications were taken regularly by 55.4% of intervention and 35.1% of the control group, p<0,001. Other factors affecting adherence were: maternal hip fracture (OR=3,09; 1,55-6,16), intermediate visits at 3 and 6 months (OR=2,41; 1,47-3,96), the presence of disability group (OR=2,03; 1,35-3,06). Conclusion: Patient education in the classroom in small groups using interactive methods more effectively influences adherence than getting the information from a booklet.