The management of patient with osteoporosis in clinical practice

Osteoporosis is a systemic skeletal disorder characterized by increased bone fragility, which is associated with an enhanced fracture risk. The first fracture often represents indeed the clinical manifestation of this condition. In the present document we provided an overview of the economic and clinical impact of a not-adequate therapeutic appropriateness and suboptimal adherence to osteoporosis therapy, that are both widely reported in literature despite osteoporotic treatments have proved their efficacy in reducing fracture risk. Adequate treatment and adherence were reported to be associated with a lower risk of re-fracture and all-cause mortality. Moreover, healthcare costs in osteoporotic patients with previous fractures were significantly lower in those receiving osteoporosis treatment rather than among untreated patients. Nevertheless, these two key-factors are not improving over time. The measurement of indicators of adherence and therapeutic appropriateness allows to analyse the utilization profile of the drugs indicated for the treatment of osteoporosis and to evaluate the presence of possible deviation between the prescriptive behaviours observed in clinical practice and the recommendations reported in the guidelines. The periodic monitoring of such indicators together with prescribing audit activity could represent a useful tool for the optimization of osteoporosis management and to achieve a correct resource allocation.