老年男性骨质疏松症患者口服阿仑膦酸钠的依从性分析

  目的 调查老年男性骨质疏松症患者口服阿仑膦酸钠的依从性，探讨影响服药依从性的相关因素。方法 入选2011年1—6月在解放军总医院门诊确诊骨质疏松症并开始口服阿仑膦酸钠治疗的老年男性患者145例，调查其服该药1年的依从性，根据药物占有率（MPR）分为依从性好组（MPR≥80%）和差组（MPR<80%），比较两组差异，分析影响依从性的因素。结果 随访到139例患者，其中依从性好者32例（23.02％)，依从性差者107例（76.98％)；对筛选出的影响服药依从性的因素进行logistic回归分析，结果显示，骨痛(OR值0.69，P=0.043)、无人提醒用药（OR值1.37，P=0.025）、担心药物副作用(OR值1.49，P=0.018)、服药种类＞7种(OR值1.30，P=0.036)、不清楚远期疗效(OR值1.39，P=0.021)为影响服药依从性的因素。结论 老年男性骨质疏松症患者口服阿仑膦酸钠治疗的依从性差；降低服药依从性的因素有：无人提醒服药、担心药物副作用、服药种类＞7种和不清楚远期疗效；骨痛可提高患者服药依从性。

The compliance in elderly male with osteoporosis treated with oral alendronate

Objective To explore the compliance in elderly male with osteoporosis treated with oral alendronate and analyze the factors which affect the therapeutic compliance. Methods A total of 145 elderly male patients diagnosed with osteoporosis who had been initiated the treatment of oral alendronate in our clinic during January to June in 2011 were enrolled in the study. The medication compliance of one year was investigated. According to the different medication possession ratio (MPR), MPR≥80% was considered as adherent and MPR<80% was considered as non-adherent. The difference in the two groups was compared and the factors which affect the therapeutic compliance were analyzed.Results A total of 139 patients had been followed up with 32 adherent cases (23.02%) and 107 non-adherent cases (76.98%). Logistic regression analysis showed the factors which affected the therapeutic compliance as the following: ostealgia (OR=0.69,P=0.043), no-reminder (OR=1.37, P=0.025), concern about drug related side effect (OR=1.49, P=0.018), more than 7 kinds of drugs (OR=1.30, P=0.036) and uncertain long-term effect (OR=1.39, P=0.021).Conclusions Compliance of oral alendronate to treat osteoporosis in elderly male patients is poor. Ostealgia can promote the drug compliance. The factors which could decrease the drug compliance are no-reminder, concern about drug related side effect, more than 7 kinds of drugs and uncertain long-term efficacy.