Evaluation of the Use of Subcutaneous Medicines for Osteoporosis in Patients of a Tertiary Hospital

Abstract

BACKGROUNDOsteoporosis (OP) is the most prevalent skeletal disease and can increase the risk of fracture. Within the pharmacological arsenal available for the control of OP, there are some options for subcutaneous (SC) use, such as denosumab (DNS), teriparatide (TER) and romosozumab (ROM). Adherence and persistence to treatment with SC use are influenced by age, cognition, needle anxiety, fear of losing medication and availability of a caregiver. The aim of this study was to evaluate the profile of patients using SC medication for OP and some factors that can impair the success of the treatment. METHODSAn observational, cross-sectional study was carried out through the application of a questionnaire to patients diagnosed with osteoporosis and using DNS and TER, followed up at the rheumatology's center of a tertiary hospital. RESULTForty-two patients were interviewed, 64% using DNS and 36% using ER, 95% being female, with an average age of 76.97 years. As expected, in TER (daily use medication), 100% were administered at home and only 13% of cases reported difficulty in application. In DNS (semestral medication), on the contrary, 74% of patients preferred application in a health unit (HU) for convenience or guidance from the medical team. In home cases (TER+DNS), 59% were applied by a caregiver and 41% were self-administered (p = 0.05). No statistical difference was found in relation to the delay in medication application among patients who used it at home or in a health unit (p = 0.59). The vast majority (90%) knew the correct way to store the medication in the refrigerator and 95% did not consider instability in the electrical network as a problem. CONCLUSIONThe choice of a SC medication must undergo a careful analysis of factors such as the convenience of choosing the place for application (home X HU), availability of a support individual (caregiver), in addition to intensive education of the patient and family regarding the various aspects of the chosen drug.