Background: Current standard of care guidelines encourages the daily consumption of calcium and vitamin D Supplementation in conjunction with osteoprotective medications such as Denosumab (a RANK-L inhibitor) and Bisphosphonates in patients at risk of skeletal related events associated with cancer. Compliance to calcium and vitamin D therapy is paramount for effective prevention of osteoporotic fractures.
Aims: To examine rates of patient-reported prescribing of calcium and vitamin D supplementation in the setting of bone modifying supportive care.
Methods: Data were extracted by the chemotherapy prescribing system (CHARM) to identify patients receiving bone resorptive agents. Patients prescribed Denosumab, Pamidronate or Zoledronic Acid were invited to participate. Patients were asked ‘are you prescribed calcium or vitamin D supplementation?’- Patients who answered ‘yes’ were then invited to participate in a 13 question survey adapted from the eight-item Morisky Medication Adherence Scale (MMAS-8) along with demographic data which was collected and analysed. For patients answering ‘no’, or ‘unsure’, only demographic data were collected.
Results: 348 patients were invited to participate in the study, with 105 patients recruited overall. 44 patients (41 %) answered ‘Yes’ to being prescribed calcium/vitamin D supplementation. 49 patients (49%) answered ‘no’ to the same question, and 12 patients were ‘unsure’ (11.4%). 37% of Multiple Myeloma patients, 62% of breast Cancer Patients and 27% of patients confirmed being prescribed calcium and vitamin D supplementation. It was reported that patients with 0-5 concomitant medications were most likely to respond ‘yes’ to being prescribed supplementation (50%) when compared with 6-10 (33%) and more than 10 (27%) concomitant medication groups.
Conclusion: This small observational study has demonstrated that patient reports of being prescribed calcium and vitamin D supplementation are not aligned with current guidelines. Further research in this space would examine gaps in processes to improve on prescribing rates and optimize patient care.