骨质疏松药物治疗率和依从性

The treatment rate and compliance of anti-osteoporosis drugs

骨质疏松症(osteoporosis,OP)是一种以骨量低下、骨微结构损坏,导致骨脆性增加,易发生骨折为特征的全身性骨代谢性疾病。骨质疏松性骨折是骨质疏松常见的并发症,多见于老年人,但在其他年龄段也有可能发病。脆性骨折好发部位多集中在髋关节、脊柱及腕关节。目前有多种现成的及有效的药物治疗骨质疏松症,如双膦酸盐、降钙素等。但由于医师及患者对骨质疏松知识不够熟悉、患者过度担心药物不良反应、抗骨质疏松药价格过高等因素的影响,骨质疏松症的患者接受药物治疗率与依从性仍较低,这导致了骨密度增加减慢,骨折发生率增加,很大程度的加重了临床和经济负担。因此,提高骨质疏松患者的药物治疗率及依从性变得至关重要,早期的抗骨质疏松治疗和长期坚持服药可以缓解骨量流失甚至提升骨量,显著降低患者骨折风险。本文主要回顾综述了骨质疏松药物治疗率及依从性现状,影响药物治疗率和依从性的原因,以及提出改善骨质疏松药物治疗率和依从性的措施。

Osteoporosis(OP)is a systemic metabolic bone disease with decreased bone mass,destructive micro-structure,and increase of the fracture risk.Osteoporotic fracture is a common complication of osteoporosis,which happens mostly in the elderly,but it may also occur in other age groups.The most common sites of fragility fractures occur in the hip,spine,and wrist joints.There are a variety of available and effective treatment method for osteoporosis,such as bisphosphonates and calcitonin.However,due to factors such as insufficient knowledge of osteoporosis among doctors and patients,patients’excessive concerns about side effects of drugs,and high prices of anti-osteoporosis drugs,osteoporosis patients still have lower drug treatment rates and compliance.This leads to a slower increase in bone mineral density and an increase in the incidence of fractures,greatly increasing the clinical and economic burden.Hence,early anti-osteoporosis treatment and long-term adherence to medication can alleviate bone loss and even increase bone mass,which significantly reduces the risk of fracture.This article mainly reviews the current situation of osteoporosis drug treatment rate and compliance,the causes of drug treatment rates and compliance,and puts forward measure to improve the treatment rate and compliance of anti-osteoporosis drugs.