Abstract

Osteoporosis is a highly prevalent chronic disease in the US and worldwide. The

most serious consequence of this disorder is fractures, which have a serious negative
impact on quality of life and are often the trigger for accelerated deterioration,
ultimately ending in death. Despite the availability of effective preventive treatments,
osteoporosis is frequently underdiagnosed and/or undertreated, particularly among the
elderly, who are also at greatest risk. In addition, the presence of co-morbid medical
conditions may be both a barrier to osteoporosis care and a risk factor for falls; thus
individuals with multiple co-morbid conditions may be a particularly high-risk group.
The management of osteoporosis involves improving bone health via adequate
nutrition, calcium and vitamin D supplements, and fall prevention strategies. Although
these measures are important in the management of all patients, most elderly patients
are likely to need additional pharmacological therapy to adequately reduce their
fracture risk. Several pharmacological treatments have been shown to significantly
reduce the risk of fracture, including bisphosphonates (e.g. alendronate, risedronate,
ibandronate, zoledronic acid), denosumab, raloxifene, calcitonin and teriparatide.
Despite recent advances in osteoporosis care, additional action is urgently
needed to improve the quality of life of osteoporotic patients in general and of elderly
patients in particular, since fracture outcomes are typically poorer in older than in
younger patients. This article reviews the current status of osteoporosis management,
emphasizing the need to improve osteoporosis care, with a particular focus on the US,
by the use of quality- improvement measures and incentives, which might result in an
increased awareness and improved treatment for this debilitating disease.