{
  "abstract": "Background and Importance Adherence to calcium/vitamin D (Ca/VitD) supplementation is generally poor, despite its clinical relevance. Beyond patient-related factors, formulation attributes may influence persistence. In Spain, numerous presentations coexist; identifying which characteristics affect adherence could optimise prescriptions and minimise discontinuations.Aim and Objectives To estimate adherence to Ca/VitD supplementation in adults and to identify patient, treatment, and formulation factors associated with adherence.Material and Methods A cross-sectional study was conducted in adults with at least one Ca/VitD dispensation in the health area of a tertiary hospital in Madrid (2022–2025) and >3 months of treatment. A random sample of at least 350 patients was estimated. Demographic, therapeutic, and formulation-related variables were collected, along with Likert scales (1–5) for taste, texture, and overall organoleptic assessment. Adherence was defined as fulfilment of three criteria: self-reported adherence >90%, positive Morinsky-Green test, and >90% of estimated dispensations done. Univariable logistic regressions and a stepwise multivariable analysis were performed.Results A total of 360 patients were included: 65% women, median age 71.9 years (IQR=58.6–83.1), with 8.5 chronic medications (IQR=4–13). Formulations were 50% chewable, 38.9% orodispersible, and 11.1% effervescent. Adverse events occurred in 15.3% of patients, all gastrointestinal. Overall adherence was 34.7% (95% CI=30–39.8%), compared with 70.8% self-reported (95% CI=65.9–75.3%).In univariable analysis, adherence increased with a higher number of chronic medications (OR=1.08; 95% CI=1.04–1.12), higher overall organoleptic assessment (OR per 1-point increase=1.43; 95% CI=1.17–1.76), formulations with polyols versus other sweeteners (OR=6.05; 95% CI=3.36–10.87), chewable tablets (OR=2.38; 95% CI=1.48–3.89), and female sex (OR=3.16; 95% CI=1.99–5.00). Negative predictors were longer treatment duration in months (OR=0.99; 95% CI=0.98–0.99), Ca dose >500 mg (OR=0.20; 95% CI=0.12–0.35), adverse events (OR=0.15; 95% CI=0.06–0.40), and concomitant antiresorptives (OR=0.56; 95% CI=0.34–0.91).The best multivariable model (AUC=0.83) identified the following significant predictors (p<0.05): ≥10 chronic medications, polyol-containing formulations, female sex, and maximum overall assessment as positive factors; occurrence of adverse events as a negative factor.Conclusion and Relevance Adherence to Ca/VitD supplementation was low. Organoleptic acceptability emerged as a critical determinant; an early interview after treatment initiation may facilitate formulation switching and prevent discontinuation. Chewable formulations with polyols appeared better tolerated. Patients on antiresorptives or long-term therapy may require targeted reinforcement strategies to maintain adherence.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Gregorio Marañón Health Research Institute- Madrid- Spain, Hospital Pharmacy, Madrid, Spain"
      ],
      "name": "D Gomez"
    },
    {
      "affiliations": [
        "Universidad San Pablo Ceu, Farmacología, Madrid, Spain"
      ],
      "name": "M Covadonga Iznaola"
    },
    {
      "affiliations": [
        "Gregorio Marañón Health Research Institute- Madrid- Spain, Hospital Pharmacy, Madrid, Spain"
      ],
      "name": "A De Lorenzo Pinto"
    },
    {
      "affiliations": [
        "Gregorio Marañón Health Research Institute- Madrid- Spain, Hospital Pharmacy, Madrid, Spain"
      ],
      "name": "Y Rioja-Diez"
    },
    {
      "affiliations": [
        "Gregorio Marañón Health Research Institute- Madrid- Spain, Hospital Pharmacy, Madrid, Spain"
      ],
      "name": "A Carrillo Burdallo"
    },
    {
      "affiliations": [
        "Gregorio Marañón Health Research Institute- Madrid- Spain, Hospital Pharmacy, Madrid, Spain"
      ],
      "name": "A Prieto Romero"
    },
    {
      "affiliations": [
        "Gregorio Marañón Health Research Institute- Madrid- Spain, Hospital Pharmacy, Madrid, Spain"
      ],
      "name": "M Martín Bartolomé"
    },
    {
      "affiliations": [
        "Gregorio Marañón Health Research Institute- Madrid- Spain, Hospital Pharmacy, Madrid, Spain"
      ],
      "name": "M Sanjurjo-Saez"
    }
  ],
  "title": "4CPS-049 Formulation matters: organoleptic acceptability drives adherence to calcium/vitamin D supplements",
  "uid": "e26acf2f-8970-5642-b08d-6a0462fa716a"
}