Author/Editor		Čokolič, Miro
Title		Kako povečati zavzetost za zdravljenje osteoporoze?
Translated title		How to improve the adherence in osteoporosis treatment?
Type		članek
Source		In: Novosti v osteologiji : monografija III. Osteoloških dnevov z mednarodno udeležbo, 21. in 22. oktober 2011, Medicinska fakulteta Univerze v Mariboru Maribor : Univerzitetni klinični center
Publication year		2011
Volume		str. 15-23
Language		slv
Abstract		Osteoporoza je pomemben vzrok obolevnosti in umrljivosti starejše populacije. Je najbolj razširjena presnovna kostna bolezen in je eden glavnih zdravstvenihin socialno-ekonomskih problemov v svetu. Kot kronična bolezen potrebuje dolgoročno opazovanje in spremljanje bolnika ter dobro adherenco zdravljenja, ki je slaba in bolnice imajo kljub zdravljenju povišano tveganje za zlom. Z zdravim načinom življenja lahko vplivamo na največjo doseženo kostno maso, upočasnimo upadanje s starostjo ter na ta način preprečimo pojav bolezni. Danes lahko izbiramo med dnevno, tedensko ali mesečno tableto in trimesečno, letno venozno in polletno podkožno terapijo. Pričetek zdravljenja osteoporoze v bolnišnici je zelo slab, samo 2% bolnikov v ZDA dobiva idealno terapijo po zlomu kolka, ki jo izboljša uspešna komunikacija med zdravnikom in bolnikom ob pogostih ambulantnih obiskih. Nova zdravila bodo v prihodnjih letih še izboljšala terapevtske možnosti. Ob vse večjem številu diplomiranih medicinskih sester jim je potrebno dodati novo vsebino in bi bile idealne za t. i. fracture prevention nurse, ki bi koordinirale vse potrebne aktivnosti in bi pripomogle k boljši adherenci zdravljenja bolnikov z osteoporozo. Le zavzet bolnik bo pridobival na kvaliteti kosti in si s tem zmanjšal tveganje za zlom.Osteoporosis is associated with considerable morbidity and mortality of the elderly and is the most prevalent metabolic bone disease and is one of the significant medical and socio-economical problems all over the world. Osteoporosis is a chronic disease, which needs long clinical observation and constant adherence to medication. Adherence to antiosteoporosis treatments is poor, exposing treated women to increased fracture risk. With healthy way of life we can achieve bigger peak bone mass, slow decreasing of bone mass later on and such a way hinder development of the osteoporosis. Currently there are many options available via prescription, bisphosphonates are available in a daily, weekly or monthly oral dose and a quarterly and in an annual I.V. dose or denosumab in 6 months s.c. Rates of in-hospital initiation of osteoporosis treatment for hip fracture patients are very low and may represent an opportunity to improve care, only 2% patients in USA were prescribed ideal therapy. Effective communication between doctor and patient, and follow-up visits that are more frequent would greatly improve the adherence to osteoporosis treatment modalities. Fracture prevention nurse and novel agents, particularly denosumab, but also inhibitors of cathepsin K and anabolic agents that act on Wnt signalling, will increase the therapeutic options for clinicians in the coming years. Compliant patients achieved increases in bone mass density with simultaneous fracture risk reduction.
Descriptors		Osteoporosis Osteoporoza therapy Zdravljenje