Effective Communication with Patients
At the initial consultation, where the diagnosis of osteoporosis is shared with patients, physicians and specialist nurses can positively influence adherence to treatment by clear and detailed explanation of:
- Low bone mineral density (BMD) and fracture risk
- How osteoporosis and fractures may affect them
- The need for treatment
- The benefit of treatment
- How to take the treatment correctly
- The timescale in which benefit may be achieved along with the disease prognosis
- Potential adverse effects of medications and what can be done if side effects are experienced
This needs to be reinforced by giving written literature specific to the needs of the patient, incorporating information on the diagnosis, medication and lifestyle measures. A range of information leaflets suitable for the general public are available from the National Osteoporosis Society's website and paper copies can be provided free of charge for use with your patients. Patients should be advised about the benefits of staying on treatment rather than just focusing on the risks associated with stopping treatment. Currently, half of patients receive no information regarding the importance of continuing medication. In the case of calcium and vitamin D, cycling a variety of preparations may improve compliance if patients are experiencing gastrointestinal side effects.
Newer treatments involving health professionals administering intravenous or subcutaneous medication alternatives have the potential to improve compliance as the medication is given in the presence of the health professional and at longer intervals.
Other opportunities to provide information and education include:
- Pharmacy medicines use reviews in the community
- Medication reviews in primary care
- Support programmes, delivered by a variety of professionals in primary and secondary care, voluntary bodies, charities and non-promotional pharmaceutical company initiatives involving patient prompting by post, telephone, text and email. These initiatives often have an educative element, providing information about the disease, a healthy lifestyle and the need to remain compliant with medication
- Improving public awareness of fragility fracture risk and lifestyle factors via statutory health bodies, charities and voluntary bodies, and non-promotional teams within the pharmaceutical industry.