63'KEEP TAKING THE TABLETS': DOES BRIEF TELEPHONE NURSE-LED INTERVENTION IMPROVE ADHERENCE TO OSTEOPOROSIS THERAPY?

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Abstract

Background: Poor adherence to oral osteoporosis medication is well recognised1. We designed a study to explore the impact of brief, nurse-led, telephone follow-up as a potential aid to adherence to osteoporotic therapies.

Innovation: Patients with osteoporosis were randomised into two cohorts. The ‘active management’ group received a brief, proforma-based, nurse telephone intervention at three and nine months, exploring adherence; the control group received no such intervention. All patients received a final nurse telephone contact at 12 months to explore adherence to therapy.

Evaluation: A total of 109 patients were randomised. 13 patients were lost to follow-up leaving 96 patients available for analysis (n = 50 active; n = 46 control).

Initial therapies in the active group were alendronic acid (36), strontium ranelate (7), risedronate (4) and ibandronate (3) whereas in control group Alendronic acid (40), Ibandronate (3) and Risedronate (3).

At 12 months, in the active group, 37/50 (74%) patients continued with therapy vs 33/46 (72%) in the control group. Further analysis of the nature of nurse contact at 3 and 9 months' time points revealed that at the 3 month point, 13 patients were subject of an active nurse intervention (defined as advice on dosing, need to restart previous or commence alternative therapy). 9/13 such interventions resulted in a positive benefit to treatment (assessed at subsequent point of contact). At 9 months, 9 active interventions were suggested leading to positive treatment outcomes in 5/9 cases.

Conclusion: In this study, although brief, nurse-led telephone contact at two points over 12 months failed to directly improve the single outcome of adherence to therapy. However, it was apparent that a significant minority of telephone contacts did produce an active intervention, suggesting that brief interventions of this type might be associated with therapeutic benefits.

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