Author:

Keywords:

Cost-Benefit Analysis, bone mineral density, fracture risk, Diphosphonates, Evidence-Based Medicine, nonpharmacologic management, Female, osteoporosis, Fractures, Bone, pharmacologic management, postmenopausal osteoporosis, Humans, Male, vertebral fractures, nonvertebral fractures, Osteoporosis, intervention trial, Patient Compliance, randomized-trial, Patient Selection, hip fracture, Quality of Life, Risk Assessment, monthly ibandronate, patient preference, cost-effectiveness, claims databases, Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, Medicine, Research & Experimental, General & Internal Medicine, Research & Experimental Medicine, POSTMENOPAUSAL WOMEN, VERTEBRAL FRACTURES, NONVERTEBRAL FRACTURES, RANDOMIZED-TRIAL, PATIENT PREFERENCE, COST-EFFECTIVENESS, ZOLEDRONIC ACID, HIP FRACTURE, BONE-DENSITY, RISK, 11 Medical and Health Sciences, 14 Economics, 3206 Medical biotechnology, 4003 Biomedical engineering

Abstract:

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. SCOPE: 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. FINDINGS: 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. CONCLUSION: The appropriate therapy should match individual patient needs in terms of efficacy, early onset of action, tolerability, and likelihood of patient adherence to treatment.