Skip to main content
Current Therapeutic Research, Clinical and Experimental logoLink to Current Therapeutic Research, Clinical and Experimental
. 2005 Jan;66(1):23–34. doi: 10.1016/j.curtheres.2005.03.003

Preference for and acceptability of twoformulations of a dietary supplement containing calcium plus vitamin D3: A randomized, open-label, crossover trial in adult patients with calcium and vitamin D deficiencies*

Jean Yves Reginster 1,**, JM Kaufman 2, V Gangjii 3
PMCID: PMC3964541  PMID: 24672109

Abstract

Background:

Preference for and acceptability of a drug are crucial for complianceand hence optimal treatment of diseases that require long-term management (eg, osteoporosis). The preference for and acceptability of a chewable tablet containing calcium and vitamin D3 and a dose-comparable effervescent powder were assessed in a Phase 4, randomized, open-label, crossover trial in 5 European countries (Sweden, Finland, Belgium, the Netherlands, and Greece).

Objective:

The aim of the present analysis was to compare the preference for and acceptability, including tolerability, of these 2 formulations based on the Belgian results of the previously mentioned study.

Methods:

Patients were recruited from 3 osteoporosis units and universityhospitals in Brussels, Liege, and Ghent, Belgium. Adult patients at risk for calcium and vitamin D deficiencies were enrolled. The study drugs included 2 formulations of a dietary supplement containing a combination of calcium plus vitamin D3: chewable tablets (calcium carbonate, 1250 mg; vitamin D3, 400 IU) (A) and effervescent powder (calcium carbonate, 1250 mg; vitamin D3, 440 IU) (B). Patients were randomly assigned to receive 1 of 2 treatment sequences: AB or BA. Both formulations were given PO BID for 14 days, with a switch to the alternate formulation occurring on day 15 of the study. Preference and acceptability were assessed using 2 questionnaires: one assessed 5 variables of acceptability using 11-point scales, and the other assessed preference using yes/no questions. Compliance and tolerability were recorded throughout the study, with unused dose counts and recording of adverse events (AEs), respectively.

Results:

The study comprised 200 patients, 199 of whom received at least 1 dose of study medication and were included in the intent-to-treat analysis (174 women, 25 men; mean age, 66 years [range, 30–87 years]). Preference data were available in 178 patients, 129 of whom (72.5%) preferred the chewable tablet compared with 34 (19.1%) who preferred the effervescent powder and 15 (8.4%) who had no preference (both, P < 0.001 vs tablet). The preference for the tablet was based on consistently and significantly higher mean scores on all 5 variables of acceptability (all, P < 0.001). The most common AEs were gastrointestinal (tablet, 27/192 patients [14.1%]; powder, 31/190 patients [16.3%]). Eighteen patients (9.0%) discontinued the trial due to ≥1 AE (12 receiving the tablet and 6 receiving the powder).

Conclusions:

In this study of preference for and acceptability of 2 formulations (chewable tablet and effervescent powder) of a dietary supplement containing a combination of calcium plus vitamin D3 in Belgian adults at risk for calcium and vitamin D deficiencies, the chewable tablet was preferred by a significant majority. Based on 5 variables, the tablet was found to be significantly more acceptable than the powder. Tolerability was similar between the 2 formulations.

Key words: acceptance, calcium, elderly, formulation, osteoporosis, preference, vitamin D3

Full Text

The Full Text of this article is available as a PDF (618.6 KB).

Footnotes

*

Trial investigators are listed in the Acknowledgments.

References

  • 1.Dawson-Hughes B., Harris S.S., Krall E.A., Dallal G.E. Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Am J Clin Nutr. 2000;72:745–750. doi: 10.1093/ajcn/72.3.745. [DOI] [PubMed] [Google Scholar]
  • 2.Rees M.C. The need to improve compliance to HRT. Br J Obstet Gynaecol. 1997;104(Suppl 16):1–3. doi: 10.1111/j.1471-0528.1997.tb11560.x. [DOI] [PubMed] [Google Scholar]
  • 3.Doren M., Schneider H.P. The impact of different HRT regimens on compliance. Int J Fertil Menopausal Stud. 1996;41:29–39. [PubMed] [Google Scholar]
  • 4.Cole R.P., Palushock S., Haboubi A. Osteoporosis management: Physicians' recommendations and womens' compliance following osteoporosis testing. Women Health. 1999;29:101–115. doi: 10.1300/J013v29n01_08. [DOI] [PubMed] [Google Scholar]
  • 5.Wright E.C. Non-compliance—or how many aunts has Matilda? Lancet. 1993;342:909–913. doi: 10.1016/0140-6736(93)91951-h. [DOI] [PubMed] [Google Scholar]
  • 6.Nikolaus T., Kruse W., Bach M. Elderly patients' problems with medication. An in-hospital and follow-up study. Eur J Clin Pharmacol. 1996;49:255–259. doi: 10.1007/BF00226324. [DOI] [PubMed] [Google Scholar]
  • 7.Marriott C. The effect of flavour on acceptability of antacid tablets. J Clin Hosp Pharm. 1983;8:69–73. doi: 10.1111/j.1365-2710.1983.tb00898.x. [DOI] [PubMed] [Google Scholar]
  • 8.Rees T.P., Howe I. A randomised, single-blind, crossover comparison of the acceptability of the calcium and vitamin D3 supplements Calcichew D3 Forte and AdCal D3 in elderly patients. Curr Med Res Opin. 2001;16:245–251. doi: 10.1185/030079901750120178. [DOI] [PubMed] [Google Scholar]
  • 9.Thomas J.L., Meunier P.J. Evaluation of acceptability of tolerance and observance of a new fixed combination of calcium-vitamin D. Rheumatologie. 1996;48:37–42. [in French] [Google Scholar]
  • 10.Ljunggren O, Andonopoulos AP, Lehtonen-Veromaa M, et al. Preference for andacceptability of a chewable tablet containing calcium (500 mg) and vitamin D3 (400 IU) and a country-specific, dose-comparable formulation were assessed in 5 European countries. Osteoporos Int. Submitted.
  • 11.Steovit D3 (calcium and vitamin D3 supplement) [package insert]. Brussels, Belgium:Nycomed Christiaens SCA.
  • 12.Calcit D3 (calcium and vitamin D3 supplement) [package insert]. Brussels, Belgium: Procter & Gamble.
  • 13.Gart J.J. An exact test for comparing matched proportions in crossover designs. Biometrika. 1969;56:75–80. [Google Scholar]
  • 14.Castel H., Bonneh D.Y., Sherf M., Liel Y. Awareness of osteoporosis and compliance with management guidelines in patients with newly diagnosed low-impact fractures. Osteoporos Int. 2001;12:559–564. doi: 10.1007/s001980170077. [DOI] [PubMed] [Google Scholar]
  • 15.Chapuy M.C., Arlot M.E., Duboeuf F. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med. 1992;327:1637–1642. doi: 10.1056/NEJM199212033272305. [DOI] [PubMed] [Google Scholar]
  • 16.Chapuy M.C., Chapuy P., Thomas J.L. Biochemical effects of calcium and vitamin D supplementation in elderly, institutionalized, vitamin D-deficient patients. Rev Rhum Engl Ed. 1996;63:135–140. [PubMed] [Google Scholar]
  • 17.Chapuy M.C., Pamphile R., Paris E. Combined calcium and vitamin D3 supplementation in elderly women: Confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: The Decalyos II Study. Osteoporos Int. 2002;13:257–264. doi: 10.1007/s001980200023. [DOI] [PubMed] [Google Scholar]

Articles from Current Therapeutic Research, Clinical and Experimental are provided here courtesy of Elsevier

RESOURCES