Shire plc has launched a new UK adherence programme, called 'Be Active', to support patients who have been prescribed Calcichew D3 Forte (1250mg calcium carbonate and 400IU colecalciferol). Current guidance highlights the importance of calcium and vitamin D supplementation in the elderly at risk of falls and fractures.1 2, 3 However, adherence to calcium and vitamin D supplementation in the UK is low, with 30% of UK patients regularly reporting missing a dose of calcium/vitamin D supplementation.4 This may contribute to more falls and fractures among the elderly 5, 6 and increase the burden on the healthcare system. 7, 8, 9

The benefit of supplementation of populations at risk of osteoporosis with calcium and vitamin D is well established.6 It has been shown to reduce falls10 and fractures11 and increase bone mineral density12 in the elderly. According to a study carried out in the last five years, calcium and vitamin D can reduce the risk of falling by 49%.13*

The 'Be Active' adherence programme aims to raise awareness of the practical steps patients can adopt to maintain their independence and mobility. Simple tools have been developed as part of the programme, including a DVD and quarterly magazine to help patients make informed choices about lifestyle, diet and supplementation. Patients who have been prescribed Calcichew D3 Forte can enrol in the programme through their GPs.

Commenting on the launch, Dr Opinder Sahota, Consultant Physician at Queens Medical Centre University Hospital, Nottingham, said: "This is a welcome addition to the support HCPs can provide to help improve the lives of elderly patients. Falls and fractures impinge on an elderly patient's quality of life hugely, often leaving them housebound and less independent. Elderly patients also often have a heavy pill burden and adherence programmes can help ensure they take their medication as instructed by their doctor."

*Compared with calcium alone

Research has shown that patients in the UK who could be benefiting from calcium and vitamin D supplements are either not receiving them or taking them incorrectly.4 Results from a recent survey of postmenopausal women diagnosed and treated for osteoporosis, show that patients in the UK are among the lowest users of supplements in Europe, with only 37% of those questioned taking calcium and vitamin D.4 This compares with 46% of patients in France and 49% of patients in Germany.4 The same survey showed that patients in the UK are also among the least likely to receive complete, detailed explanation regarding supplementation from their GP.4

Senior Product Manager at Shire, Cheryl Eubank, commented, "Falls and fractures can be life-threatening for the elderly. The threat can be reduced through simple modifications of lifestyle and their environment. By highlighting this to the elderly, we hope to provide patients with the opportunity to live a fuller life for longer, without fear of falls."

Over 300,000 patients present to hospitals in the UK with fragility fractures in the UK, leaving healthcare providers burdened with around £2 billion worth of healthcare costs.7 According to study results, up to 24% of fallers sustain a serious injury14 that can lead to poor quality of life, despite costly hospital and lengthy rehabilitation programmes.15

The benefits of calcium and vitamin D supplementation for those at risk of osteoporosis are well established, with some intervention studies showing they prevent fragility fractures.6 Vitamin D regulates the level of calcium in the blood, which stimulates bone growth.16 Inadequate dietary calcium leads to increased bone turnover and bone loss17, and vitamin D deficiency has been shown to lead to abnormalities in muscle contraction and relaxation.18 These are risk factors for fractures and falls respectively.17, 19

References

1. SIGN 71. Management of osteoporosis. 2003 71 05 933:1
2. RCP. Osteoporosis. Clinical Guidelines for Prevention and Treatment, 2000. July: 1-14
3. NOGG. Osteoporosis Clinical Guideline for Prevention and Treatment. 2008
4. Boonen. Patients Behaviours and Understanding of the Importance of Calcium and Vitamin D Supplementation. Presented at ASBMR. 2008
5. Flicker L et al. JAGS. 2005; 53: 1881-1888
6. Bonjour JP et al. Br J Nutr. 2009. 1 :1-16
7. BOA Report: The Care of Patients with Fragility Fracture. June 2007
8. Parrot. Dept of Trade and Industry Rep. 2007
9. Burge. JME. 2001; 4: 51-62
10. Karkkainen. Presented at ASBMR. 2007
11. Larsen et al. JBMR. 2004; 19: 370-378
12. Jackson, R et al. NEJM. 2006; 7: 669-683
13. Bischoff H A et al. JBMR. 2003; 18: 343-351
14. Tinetti. NEJM. 1988; 319: 1701-1707
15. Fierens. Acta Chair Belg. 2006; 106: 393-396
16. Perez-Lopez. Maturitas. 2007; 58: 117-137
17. Pfeifer et al. JBMR. 2000; 15: 1113-1118
18. Boland. Endocrine Reviews. 1986; 7:434-447
19. Dawson-Hughes. JBMR. 2007; 22:59-63

Source
Shire plc