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.


CONCLUSIONS
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.
MBChB, MPH, FRACP is NHMRC-NICS/DVA Fellow and Clinical Professor, Area Rehabilitation and Aged Care, University of Western Australia.
Charles A
CA
Inderjeeth
Andrisha-Jade
AJ
Inderjeeth
Warren David
WD
Raymond
D001315:Australia; D004164:Diphosphonates / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D050723:Fractures, Bone / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D006801:Humans; D007093:Imidazoles / Q000494:pharmacology / Q000627:therapeutic use; D010024:Osteoporosis / Q000188:drug therapy* / Q000401:mortality / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D010817:Physician-Patient Relations; D017010:Reminder Systems; D000068296:Risedronic Acid / Q000494:pharmacology / Q000627:therapeutic use; D000077211:Zoledronic Acid
D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D000068296:Risedronic Acid