Patients skip treatment needs: experts

Patients are failing to take their medication properly, leading to difficulties in treating osteoporosis, experts say.

"The treatment of osteoporosis requires a long period of time, and patients' adherence to medication has a greater impact on its treatment effect. But patients are failing to take their medicine properly," says Zhu Hanmin, director of the osteoporosis diagnosis and treatment center at Shanghai's Huadong Hospital.

Osteoporosis is a disease in which bones become weak and brittle. Bone is living tissue, which keeps constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone doesn't keep up with the loss of old bone mass.

China has about 88 million osteoporosis patients, or half of the elderly population. Osteoporosis is the fourth most common chronic disease in the nation.

Osteoporosis usually affects women who are past menopause and men older than 50. In China, as many as 56 percent of women aged over 60 have suffered osteoporosis.

Bisphosphonates are the most common medications prescribed for osteoporosis treatment, which help slow the bone breakdown process. And it also has some specific administration requirements, such as fasting, remaining upright and not ingesting other medications.

Statistics show about 87 percent of Chinese patients take medicine for less than three months, Zhu told an osteoporosis forum in Shanghai in June.

"The visible treatment effect relies on patients' adherence to proper medication. But patients failing to take their medicine properly is currently one big reason for the country's poor osteoporosis therapy," Zhu says.

"Patients usually need to take medicine for at least one year to decrease the risk of fractures," Zhu says.

"Osteoporosis has become one of the most serious public health problems worldwide. Patients discontinued their therapy due to various reasons, such as the complexity and frequency of administration and drug-induced adverse effects," says E. Michael Lewieck , MD at University of New Mexico School of Medicine and director of New Mexico Clinical Research and Osteoporosis Center.

Doctors and medical experts are looking for more effective ways to increase patients' adherence, such as reducing administration frequency, monitoring patients with bone markers and bone mineral density testing, enhancing practitioner feedback and support, providing adequate instructions and increasing educational materials and sessions.

Biochemical bone turnover markers provide clinically useful evidence of the normal and pathologic processes reflecting bone metabolism or cell activity in the bone tissues.

The use of such bone turnover markers can help doctors understand the mechanism of therapeutic agents.

"The bone turnover markers can help to assess the treatment effect. In this way, for patients who discontinue their therapy or have seen less effect, doctors can change or optimize the treatment and medication plans, which will improve patients' adherence," Zhu says.