Integrated clinical view on long-term management of patients with osteoporosis

Abstract

Challenges in the long-term management of osteoporosis include limited time for patient encounters, competing healthcare priorities, under-recognition of patients at high risk for fracture, inaccurate assessment of fracture risk, poor understanding of the balance of benefits and risks with osteoporosis treatment, and poor adherence to therapy. Strategies to reduce the burden of osteoporotic fractures must address these and other challenges, customizing patient care according to clinical circumstances. Treatment decisions should be individualized with consideration of applicable clinical practice guidelines (CPGs) and all available clinical information. When pharmacological therapy is indicated, an initial drug must be chosen, treatment monitored, and decisions made on when, if ever, to withhold or change therapy. Effective risk communication and shared treatment decision-making may improve clinical outcomes. Systems-based methods, such as fracture liaison services (FLSs), may be particularly effective at secondary fracture prevention. Development of osteoporosis treatment targets might improve the care of osteoporosis.