“Nearly 80% of people who are prescribed calcium and vitamin D supplements stop taking them or take it improperly”. This is the finding of new research from Spain, which is published in the current edition of the peer-reviewed journal Climacteric.
Adequate levels of vitamin D are essential for the maintenance of strong bones, especially in post-menopausal women. Hip fractures are especially dangerous for ageing women, as it has been found that for a 50-year old woman, the risk of dying after a hip fracture over her lifetime (2.8%) is around the same as the risk of dying from breast cancer1. Vitamin D supplements can reduce the general risk of fractures, and has been shown to reduce hip fracture by 26%2.
The research group, headed by Professor Camil Castelo-Branco (Barcelona) studied patients tthroughout Spain. 1342 primary-care physicians and specialists were asked to recruit patients aged 45 years or over (both male and female), who had been prescribed with a calcium and vitamin D combination (CaVitD) at least 1 year prior to the study.
7624 patients were finally analyzed. Most patients were postmenopausal women (mean age 65.7). The main reason (56.3%) for CaVitD prescription was the onset of osteoporosis, between 2 and 5 years previously. In addition, many patients had a family history of osteoporosis (41.4%) and previous fractures (40.7%). Patients were questioned on both persistence (i.e., did they keep taking the medicine) and compliance to treatment (i.e. did they take the medicine as instructed), and asked to provide information on such things as education, and other socio-economic and health factors.
The study found that only 68% of patients had continued to take the medicine, and of those patients only 31% were taking the supplements properly. This means that only 22% of patients were taking the medicine properly after one year. There were no significant differences between men and womenñ
The body naturally produces vitamin D through exposure to sunshine, but even in sunny Spain, only 21.4% of postmenopausal women have adequate blood levels of vitamin D. It is standard practice to prescribe Calcium and Vitamin D to patients at risk. However the patient must continue to take the supplements to maintain the protective effect. The study found that those patients who had already been diagnosed with osteoporosis were more likely to continue taking the supplements. In contrast, those patients who were older, had a lower level of education, lived alone, more frequently consumed tobacco and alcohol and had a history of prolonged immobilization, were more likely to give up the treatment.
--According to Professor Castelo-Branco
“The amount of people who give up on treatment, or don’t take the medicine properly, is a real and recognised concern, and is one of the biggest problems in medical treatment. This is a reasonably large study, and reflects the findings of another study in Italy; we may be looking at a general problem which exists in most European countries.
We need to develop effective strategies that lead to ensure that patients continue to take osteoporosis medicines, and that they do so properly. We might, for example, look at simplifying the way that patients take the medication, or better educate patients about the disease and its treatment.
People suffering or at risk from osteoporosis need to have individual management and treatment, and their progress needs to be measured and fed back to the patients. There is some work underway3 to which might lead more accurate blood measurements of vitamin D. This could be a big step forward in feeding back to patients the necessity to continue taking the supplements. If we have nearly 80% of patients who don’t take their osteoporosis medicines properly, then it’s not their fault; we need to look at ways of encouraging them.
However, the situation just now is that many people lose track of taking a simple, cheap and effective medicine. And this means that a lot of people are suffering or even dying unnecessarily”.
--In an additional comment, Patrice McKenney, CEO of the International Osteoporosis Foundation (IOF) stated,:
“Vitamin D deficiency is a global problem which has been linked to the pathogenesis of osteoporosis, muscle strength and fall-related fractures. It is I mportant that high risk individuals, including people with osteoporosis, homebound or institutionalized people with limited sun exposure and those experiencing malabsorption, consider supplementation to achieve adequate levels of vitamin D.”
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