Medication Selection and Patient Compliance in the Clinical Management of Osteoporosis

Background: Osteoporosis contributes significantly to morbidity and mortality. Antiresorptive therapy is effective in primary and secondary fracture prevention, but compliance with bisphosphonate therapy is poor, resulting in poorer patient outcomes.

Objective: The objectives of this article are to aid clinicians' treatment selection and improve patient adherence.

Discussion: A literature review of treatment options and factors contributing to poor patient treatment adherence was conducted for this article. The effectiveness of osteoporosis treatment is reduced because of poor adherence. This is associated with a lack of patient understanding of their condition, perception of fracture risk and concerns about adverse events. Appropriate treatment selection and novel oral and parenteral options may help improve compliance. Increasing treatment adherence requires clinicians to improve patient education. Discussion around patient preferences, implications of fragility fractures, minimising side effects and efficacy of treatment is essential despite the lack of any tangible 'symptom' benefit.