Evaluación de la adherencia al tratamiento con calcio y vitamina D en ancianos de una zona básica de salud

Abstract

Background and objectiveThe vitaminD deficiency is high in the elderly population. Calcium and vitaminD supplements is a frequently used measure in individuals at risk for falls and/or fractures. However, this practice has achieved a low level of compliance. The aim is to assess the adherence to treatment with calcium and vitaminD in elders with hypovitaminosisD in an urban area of Madrid. Patients and methodsIntervention study performed on 438 individuals ≥65years from the ‘Peñagrande Cohort’ with hypovitaminosisD that were treated with calcium and vitaminD. Adherence at 3 and 12months was assessed using the Morisky-Green and counting of prescriptions written. ResultsA total of 413 of the 438 individuals with hypovitaminosisD were analysed (18 patients were not treated because of contraindications, and 7 were considered lost). At 3 and 12months, 63.9% and 47.2%, respectively, were adherents. After a brief educational intervention, 19.3% of individuals without adherence at 3 months became good compliers when measured at one year. Comorbidity was associated with lower rates of adherence to treatment after one year (46.3% versus 35.2%, P=.027). The main cause of non-adherence to calcium was digestive intolerance, and due to oversights for vitaminD. Concordance between adherence assessed by the Morisky test and counting of prescriptions written was high (Kappa index=69.8%). ConclusionsNon-adherence to chronic treatment with calcium and vitaminD is a relevant problem in elderly. It is important to assess adherence and implement health education strategies in clinical practice.