Osteopenia en atención primaria: ¿debemos ser más rigurosos?

Abstract

Aim To describe the treatment prescribed to osteopenic women seen at an urban primary health care centre and the treatment compliance of those patients with a prescription of calcium and/or vitamin D. Materials and method Cross-sectional study, osteopenic women diagnosed by bone densitometry between February 2005 and January 2006 (n = 121). Clinical history review: demographic information; previous clinical history of bone fracture, type of fracture; parental history of fractures; tobacco use; osteoporosis-related medication or disease; dietary and sun exposure assessment; calcium, vitamin D and raloxiphene/bisphosphonates prescription; mean daily dose of calcium and vitamin D supplements collected at the pharmacy by patients. Analysis of treatment prescription and compliance according to the information collected was performed. Results Mean age, 61.9 ± 9.1 years; 90.7% post-menopausic. The dietary assessment was performed in 30.5% of the women included in the study. The drug prescription was as follows: calcium 74.6%, vitamin D 68.6% and raloxiphene/bisphosphonates 16.1%. All drug prescriptions were associated with lower T-score values. The patient's compliance of calcium supplements has been calculated as mean of 423.8 ± 321.7 mg/day, and 343.1 ± 225.9 IU of vitamin D; with no association with any of the studied variables. Conslusions We identified greater drug prescription in those patients with a lower T-score. The clinical history of previous fracture did not show association with drug prescription nor a better compliance. There was a lack of information about relevant issues in the clinical history of the osteopenic women included in the study. The patient's compliance of calcium and vitamin-D supplements is very variable.