Background:
Patients prescribed denosumab, as supportive care for bone metastasis, should also be prescribed calcium and vitamin D supplementation to increase bone mineral density, and reduce denosumab-related side effects such as hypocalcaemia.
Aims:
To assess adherence to prescribed calcium and vitamin D supplementation, in line with best practice guidelines (BPG), in patients receiving denosumab for cancer-related treatment. BPG is defined as treatment compliant with eviQ recommendations.
To identify barriers to adherence and reasons for non-adherence to prescribed supplementation therapy.
Methods:
35 patients receiving cancer-related denosumab therapy participated in a survey conducted over the phone with a pharmacist, assessing the knowledge of, and adherence to, their supplement schedule. Survey data was collected to compare the patient’s adherence against the actual treatment prescribed by the doctor. Patients were asked to identify a cause for non-adherence if non-adherence was reported.
Results:
49% (17) of patients demonstrated complete adherence to eviQ guidelines, 28% (10) demonstrated partial adherence to a regimen and 23% (8) patients demonstrated no adherence at all. 23% of patients surveyed had no knowledge of their prescribed supplement regimen or understanding of importance of these supplements. Of the non-adherent patients, 44% (8) had never started any supplementation, 33% (6) patients were taking one of the two prescribed supplements, and 8% (3) patients were recorded as non-adherent due to forgetfulness.
Conclusion:
Due to the high rates of non-adherence amongst this observational group, an expanded study is being developed to assess and determine rates and degree of adherence to calcium and vitamin D supplementation. Treatment groups will also include patients receiving bisphosphonates to capture more of this patient population and identify factors and barriers to adherence. This information will be useful to implement processes to address these barriers and thus, improve patient outcomes.