Compliance

A critical factor for therapeutic success

Ensure patient compliance to help maximize therapeutic effectiveness

Patients who adhered to study medication reduced their risk of hip fracture by 29% (the effect was noticed in patients who were taking ≥ 80% of their medication).1 If you want your patients to experience the benefits of observed-under-trial conditions with calcium + vitamin D3 supplementation (OS-CAL), they must take their calcium supplements regularly and persistently twice a day.

In the largest intervention study (36,282 participants):
“...efficacy in fracture reduction is enhanced among women adherent to calcium with vitamin D supplementation or is present only in this group.”1
New England Journal of Medicine Feb. 16, 2006
In a meta-analysis (4,508 participants):
“Poor compliance is a major obstacle to obtaining the full benefit of calcium supplementation.”2

“Trials with a higher compliance rate showed a significantly greater risk reduction than did those with lower compliance rates. Of the eight trials (n = 4508) that reported a compliance rate of 80% or more, the treatment was associated with a 24% risk reduction in all types (p<0.0001).”2
The Lancet Aug. 25, 2007

OS-CAL — Designed with compliance in mind

  • Patients can take fewer and smaller tablets per dose because it contains approximately 60% more elemental calcium per tablet than calcium citrate tablets

  • Directions tie dosing to meals, thus providing a simple memory cue

  • Coated smaller tablets help enhance ease of swallowing

  • Availability of great-tasting sugarless, chewable tablets enhance acceptance and convenience

  • No significant side effect differences between OS-CAL and placebo in terms of constipation, bloating, and gas

  • Package labeling aids compliance between OS-CAL and bisphosphonate medications

    • It helps ensure that patients are informed to take their bisphosphonate medication on an empty stomach, and to take OS-CAL with meals

“Adequate calcium is considered a key component of any bone-protective therapeutic regimen.”

“Encouraging adequate intake of calcium should be a goal of all healthcare management plans for peri- and postmenopausal women. ... When it is necessary to increase calcium intake, most experts recommend consuming 500 mg of calcium or less at one time to maximize absorption.”3
North American Menopause Society Position Statement 20063

Hurdles to compliance4

Some patients are just reluctant to take any kind of treatment or medication. Also, since many patients are largely asymptomatic, they may not be worried about their osteoporosis. In fact, a recent study (n = 979) showed that 58% of patients (largely asymptomatic) were not worried about their osteoporosis and were not afraid of a fracture. Most thought that an osteoporosis therapy would not cure them of their osteoporosis and could not prevent a new fracture.

“Because calcium carbonate has about twice as much elemental calcium as calcium citrate ... fewer tablets are required to achieve a given dose of elemental calcium, resulting in decreased cost and a potentially increased rate of patient compliance.”
Journal of Women's Health — Sunyecz, 20055

References

  1. Jackson RD et al. "Calcium plus Vitamin D Supplementation and the Risk of Fractures." February 16, 2006; N Engl J Med. 354(7)
  2. Tang B et al. "Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people 50 years and older: a meta-analysis." The Lancet August 25, 2007;370:657-666
  3. NAMS Position Statement: The role of calcium in peri- and postmenopausal women. Menopause. Vol 13(6)2006:859-879
  4. Gold D. "Compliance with Osteoporosis Medications: Challenge for Healthcare Providers." Medscape Ob/Gyn & Women's Health. 2005;10(1)
  5. Sunyecz JA, Weisman SM. "The role of calcium in osteoporosis drug therapy." J Women's Health. 2005;14:180-192