Phone coaching benefits some on bone meds

March 8, 2012

In an effort to improve compliance with osteoporosis therapy, researchers tested telephone counseling as a motivator. Read more for the results.

The study included approximately 2,100 men and women (mean age, 78) who had recently received new prescriptions for osteoporosis drugs. The counselors used a motivational interviewing framework and tried to determine why each person skipped taking the drugs. They then tailored their comments to convince each person to return to treatment. The researchers hoped for a 10% increase in adherence as a result of the telephone counseling.

After 1 year, only 49% of the intervention group and 41% of the control group filled their prescriptions. And almost no differences existed in the number of self-reported fractures or falls.

Telephone counseling doesn’t significantly improve overall compliance with osteoporosis drugs, but it can produce modest improvement in some patients, according a new randomized trial.

Published online February 27 in Archives of Internal Medicine, the study included approximately 2,100 men and women (mean age, 78) who had recently received new prescriptions for osteoporosis drugs. They were recruited from a large pharmacy benefits program for Medicare beneficiaries. The co-pay for the osteoporosis drugs was no more than a few dollars.

All participants received educational materials by mail. Half also were counseled via telephone 8 times. The counselors used a motivational interviewing framework and tried to determine why each person skipped taking the drugs. They then tailored their comments to convince the person to return to treatment.

The researchers hoped for a 10% increase in adherence as a result of the telephone counseling. But after 1 year, only 49% of the intervention group and 41% of the control group filled their prescriptions, and almost no differences existed in the number of self-reported fractures or falls. Intervention did improve compliance in participants aged 65 to 74 (median medication possession ratio [MPR], 48% vs 41% for intervention and control groups, respectively) and in those without a previous fracture (median MPR, 49% vs. 46% for intervention and control cohorts, respectively; P=.045 for interaction).

Cost of the intervention, including interviewer training, was approximately $281 per patient. The most commonly reported reasons that patients skipped treatment were forgetfulness, not liking the way the drugs made them feel, or thinking they didn’t need treatment.

Read other articles in this issue of Special Delivery.