Pharmacological management of osteoporosis and concomitant calcium supplementation in a Portuguese urban population: the EpiPorto study (2005-2007).

INTRODUCTION We aimed to describe the pharmacological management of osteoporosis in the general population, with emphasis on the inclusion of calcium supplementation. METHODS We interviewed 1511 participants in an evaluation of a cohort of Portuguese adults. Antiresorptive therapy and calcium supplementation in the previous year were recorded. Socio-demographic characterisation included education, occupation, marital status and source of medical care. The participants' osteoporosis history and menopause age were noted. Dietary calcium intake was quantified using a food frequency questionnaire and a calcaneus quantitative ultrasound was conducted. RESULTS Antiresorptive drugs had been used by 11.4% of women and 1.2% of men in the previous year. Bisphosphonates were the most referred subgroup (88% of all therapies), followed by raloxifen, and calcitonin. Overall, 43% of women reported using calcium in combination with bone-sparing drugs. Combination therapy was more frequent among older women (> or =70 years old: 63%), those with the highest educational level (>12 schooling years: 49%), blue-collar occupations (55%) and private healthcare (43%). Women with longer postmenopausal periods (>10 years: 42%) and those with the highest spontaneous calcium intakes (highest tertile: 44%) reported combination therapy more frequently. CONCLUSION Although treatment with bone-sparing drugs is frequent, the management of osteoporosis does not systematically include the recommended calcium supplementation.