Osteoporosis management: translating research into optimal fracture protection II.
BACKGROUND
Osteoporosis is a prevalent disease with substantial individual and socioeconomic consequences. The challenges faced by physicians include identifying individuals at high risk of fracture, selecting the optimal treatment plan for each patient, and educating patients regarding their role in the effectiveness of therapy.


METHODS
This article discusses screening and patient selection for osteoporosis treatment, as well as available bisphosphonate therapies. Data on patient adherence and cost-effectiveness are also reviewed. The aim is to raise awareness among clinicians of the importance of osteoporosis assessment and of the differences in clinical outcomes between therapies.


RESULTS
Reviewed data indicates that risk-factor assessment is invaluable in diagnosing osteoporosis and guidelines are available which should be consulted to help determine which patients need treatment. When selecting a treatment plan, the differences between therapies in terms of vertebral and nonvertebral efficacy, timing of onset of action, and tolerability should be considered. Furthermore, patient adherence to a particular therapy will affect its effectiveness and can be improved through active patient education. Finally, given the large number of affected individuals, cost-effectiveness of therapies should be considered.


CONCLUSIONS
The appropriate therapy should match individual patient needs in terms of efficacy, early onset of action, tolerability, and likelihood of patient adherence to treatment.
Georgetown University Medical Center, Washington, DC, USA. singeraf@gunet.georgetown.edu
Andrea J
AJ
Singer
Steven
S
Boonen
D003362:Cost-Benefit Analysis; D004164:Diphosphonates / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D005260:Female; D050723:Fractures, Bone / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D010349:Patient Compliance; D018579:Patient Selection; D011788:Quality of Life; D018570:Risk Assessment
D004164:Diphosphonates