Osteoporosis is a condition which features low bone density, causing bones to become weak, brittle and fracture more easily. It affects around 3.6 per cent of Australians of all ages, including 11.5 per cent of Australians with arthritis.(Click here to read our article Osteoporosis and Arthritis: What You Need to Know.)
People are often unaware they have osteoporosis until they start to experience symptoms such as sudden back pain or decreased height due to a bone fracture, especially after a minor fall or injury.
While there is no cure for osteoporosis, symptoms can be treated with effective medications and lifestyle changes. These treatments have been proven to reduce your risk of fracture by slowing the breakdown of your bones and strengthening them. Your doctor can help you develop a treatment strategy based on your risk factors and medical history.
However, recent research led by Sagarika Dey from the School of Clinical Medicine at the University of New South Wales has revealed that many people who have been prescribed anti-osteoporotic medications don’t take them as directed. For example, 50 to 70 per cent discontinue therapy within one year.
(Click here to view a PDF of the Patients’ Perspectives and Experiences of Medication Use in Osteoporosis study poster.)
The study supports current research showing that adherence to anti-osteoporotic medications is challenged by diverse patient-related, condition-related, treatment-related, socioeconomic and systemic factors. Examples of these include:
- Denying the seriousness of the condition, especially when there are little or no symptoms.
- Prioritising other conditions or lifestyle factors above managing osteoporosis.
- Believing medications are unnatural or toxic.
- Not wanting to be dependent on medications or to add to an existing medication regime.
- Being disempowered by poor quality relationships with healthcare providers.
- Being frustrated by conflicting advice or not having enough information about osteoporosis and/or its treatment.
On the other hand, the study found people were much more likely to take osteoporosis medications regularly when they were:
- Empowered by strong support systems.
- Had effective management strategies in place.
- Deprescribed any unnecessary medication.
- Had ample opportunities to gain knowledge about osteoporosis, its treatment and managing adverse effects.
Dey and her research colleagues propose that when healthcare professionals offer shared decision-making, tailored education and continued emphasis on treatment benefits, consumers can be empowered to take an active role in managing their condition and adhere to their treatment regime in the long term. This will go a long way towards improved outcomes for people with osteoporosis.
This information should never replace the information and advice from your treating physician. It is meant to inform the discussion that you have with healthcare professionals, as well as others who play a role in your care and well-being.
Tell Us About Your Experiences With Osteoporosis Diagnosis and Management
People with arthritis may also have (or be at risk of developing) osteoporosis. However, many of these people are not aware of the link between the conditions or how to treat osteoporosis. You can help shape our future content on these topics by completing our mini survey. Thank you.
Australian Bureau of Statistics National Health Survey: Health Conditions – Osteoporosis https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/2020-21#arthritis-and-osteoporosis
Australian Bureau of Statistics National Health Survey: Health Conditions Prevalence 2021-22 Table 12 Comorbidity of Selected Chronic Conditions. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/2020-21#data-downloads
Kothawala P, Badamgarav E, Ryu S, et al. Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. 2007. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995. https://www.ncbi.nlm.nih.gov/books/NBK74318/
Dey S, Spratt G, Koobasi M, Vleeskens C, El-Haddad C, Kelly A. Patients’ Perspectives and Experiences of Medication Use in Osteoporosis – a Qualitative Systematic Review and Thematic Synthesis [abstract]. Arthritis Rheumatol. 2022; 74 (suppl 9). https://acrabstracts.org/abstract/patients-perspectives-and-experiences-of-medication-use-in-osteoporosis-a-qualitative-systematic-review-and-thematic-synthesis/. Accessed January 3, 2023.
Yeam CT, Chia S, Tan HCC, Kwan YH, Fong W, Seng JJB. A systematic review of factors affecting medication adherence among patients with osteoporosis. Osteoporos Int. 2018 Dec;29(12):2623-2637. doi: 10.1007/s00198-018-4759-3. Epub 2018 Nov 12. PMID: 30417253. https://pubmed.ncbi.nlm.nih.gov/30417253/