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Value of a New Fixed-Combination Pack of Bisphosphonate, Calcium and Vitamin D in the Therapy of Osteoporosis

Results of Two Quantitative Patient Research Studies

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Abstract

Background: Osteoporotic patients with insufficient calcium intake and/or vitamin D insufficiency need adequate calcium and vitamin D supplementation with their bisphosphonate treatment. However, consistent intake and, therefore, the effectiveness of calcium/vitamin D supplementation may be impaired by several factors in the individual patient: low prescription rate or lack of advice to purchase calcium/vitamin D; reduced compliance because of the complexity of the regimen; or incorrect intake. There is a need to provide patients with a better way of taking bisphosphonate treatment with their calcium/vitamin D supplementation. To this end, a fixed-combination pack to help patients take the combination of bisphosphonate, calcium and vitamin D correctly and regularly has been developed.

Objective: To evaluate patients’ understanding of administration instructions, preferences and their perceptions of compliance, convenience and completeness of a fixed-combination pack of bisphosphonate, calcium and vitamin D compared with those associated with separate packs.

Methods: The new monthly fixed-combination pack of bisphosphonate, calcium and vitamin D contains four weekly boxes. Each box contains a blister pack with one swallowable risedronate 35 mg film-coated tablet and six sachets of calcium/vitamin D effervescent granules (calcium 1000 mg and vitamin D3 [colecalciferol] 880 IU) for dissolution in water as an oral solution, together constituting 1 week of therapy, accompanied by a patient information leaflet. Two quantitative patient research survey studies were conducted using standard questionnaires in face-to-face interviews with 400 postmenopausal women in several French cities. Participants were given the combined pack and two separate packs (risedronate 35 mg once weekly and calcium/vitamin D effervescent granules in sachets). In the first study, participants’ understanding of administration instructions and preferences were evaluated. In the second study, participants’ perception of compliance, convenience and completeness of the new combination pack of risedronate 35 mg plus calcium/vitamin D compared with two separate packs were evaluated.

Results: Participants asked about the combined pack answered a significantly higher proportion of questions about intake instructions correctly (80.3%) than participants asked about the two separate packs (70.7%) [p = 0.0004]. The combined pack was preferred by 72% of participants (p < 0.0001) for several reasons. Compared with separate packs, the combined pack was considered easier to use by 63% and easier to remember to use by 67% of participants. Participants believed that use of the combined pack would be more likely to help them take their bisphosphonate regularly (66%) and correctly (67%), and to take their calcium/vitamin D supplementation more regularly and correctly (68%), than use of separate packs. Seventy percent of participants believed that use of the combination pack would help them to not forget to take calcium/vitamin D supplementation.

Conclusion: Use of the fixed-combination pack of risedronate 35 mg plus calcium/vitamin D once weekly could increase the likelihood that postmenopausal osteoporotic patients will receive a complete bisphosphonate, calcium and vitamin D therapy course and is likely to enhance correct intake of combination therapy. Use of this fixed-combination product will provide patients with a tool for improving adherence to recommended osteoporosis therapy and optimize the effectiveness of such treatment.

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Acknowledgements

No sources of funding were used to assist in the preparation of this article.

Johann D. Ringe has received consultancy fees and other payments from Merck Sharp & Dohme, Procter & Gamble Pharmaceuticals-Germany GmbH, Lilly Deutschland and sanofi-aventis Deutschland GmbH. Patrice Fardellone has received consultancy fees and other payments from Procter & Gamble Pharmaceuticals France. H.-P. Kruse has received consultancy fees and other payments from Merck Sharp & Dohme, Procter & Gamble Pharmaceuticals-Germany GmbH, GlaxoSmithKline Deutschland, Roche Pharma AG, Lilly Deutschland, Novartis, sanofi-aventis Deutschland GmbH and Servier Deutschland. Michael Amling has received consultancy fees and grants from Merck Sharp & Dohme, Procter & Gamble Pharmaceuticals-Germany GmbH, Novartis, Servier and sanofi-aventis Deutschland GmbH. Stefan A.P. van der Geest is an employee of Procter & Gamble Pharmaceuticals, Switzerland. Gerd Möller was an employee of Procter & Gamble Pharmaceuticals-Germany GmbH from 15 May 2001 to 5 September 2008.

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Authors and Affiliations

  1. Medizinische Klinik IV, Klinikum Leverkusen, Teaching Hospital of the University of Cologne, D-51375, Leverkusen, Germany

    Johann D. Ringe

  2. Service de Rheumatologie, Hôpital Nord, Amiens, France

    Patrice Fardellone

  3. Osteoporosezentrum Hamburg-Neuer Wall, Neuer Wall, Hamburg, Germany

    Hans-Peter Kruse

  4. Zentrum für Biomechanik und Skelettbiologie, Experimentelle Unfallchirurgie, Osteologische Schwerpunktambulanz, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

    Michael Amling

  5. Medical & Technical Affairs, Procter & Gamble Pharmaceuticals, Petit-Lancy, Switzerland

    Stefan A. P. van der Geest

  6. Sandstrasse, Duisburg, Germany

    Gerd Möller

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Ringe, J.D., Fardellone, P., Kruse, HP. et al. Value of a New Fixed-Combination Pack of Bisphosphonate, Calcium and Vitamin D in the Therapy of Osteoporosis. Drugs Aging 26, 241–253 (2009). https://doi.org/10.2165/00002512-200926030-00005

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