Endocrine Abstracts

Background: Vitamin D supplementation is an integral component of treating patients with osteoporosis/osteopenia. Data have shown that monthly vitamin D supplementation is not inferior to daily regarding target vitamin D levels. Moreover, it has been argued that monthly supplementation might increase adherence. Patients’ adherence and satisfaction with daily versus monthly vitamin D supplementation have been hardly investigated. The current study evaluated osteopenic/osteoporotic patients’ adherence and satisfaction from vitamin D supplementation after switching from monthly to daily (MtD) dosing and vice versa (DtM).

Methods: Ambulatory osteopenic/osteoporotic patients visiting the endocrine clinic at a tertiary medical center were asked to switch their vitamin D supplementation from MtD and vice versa. Total monthly dose remained unchanged. Patients answered questionnaires regarding socio-demographic and medical status, compliance with vitamin D dosing (Morisky Adherence Scale 8; MMAS-8), satisfaction with vitamin D regimen and physical functional status (OPAQ-15) at baseline and 6 months after switching. Each group was compared to its baseline characteristics and to the parallel group.

Results: Among 72 ambulatory patients recruited (mean age 71.5±7.4, 91.7% female), 52 (72.2%) were switched from DtM treatment and 20 (27.7%) from MtD. 84.7% were taking anti-osteoporosis medications, 51.4% had a prior osteoporotic fracture and 76.5% were taking calcium supplementation. Baseline vitamin D level was 86.1±17.2 nmol/l. Both groups expressed good baseline compliance (mean 98.1%) with vitamin D regimen (MMAS-8 score ≥8). Baseline satisfaction with vitamin D regimen was good: 74% and 77.7% from DtM and MtD dosing, respectively. Baseline physical status was good in 63.9% and moderate in 33.3%. After switching, satisfaction level, adherence to vitamin D regimen, vitamin D level and functional capacity were not different compared to baseline. Yet, 68.8% of MtD and 52% of DtM patients wanted to remain on the current regimen. Among patients who experienced both regimens, 56.1% preferred daily and 43.9% preferred monthly.

Conclusion: Patients with osteopenia/osteoporosis had good adherence to monthly and to daily vitamin D regimens and expressed high level of satisfaction with them. All parameters remained stable after switching regimens. Most MtD patients preferred the new regimen. Additional large-scale studies are needed to evaluate the effects of various dosing regimens on patients’ satisfaction and adherence.