Osteoporosis pharmacological prevention and management in older people

Abstract

Background: Osteoporosis remains undertreated in Australian primary care, with as few as 30% of postmenopausal women with a fracture and 10% of men with osteoporosis receiving pharmacological treatment. Objective: This article presents an overview of the pharmacological management of osteoporosis in older people in the general practice setting. Discussion: Lifestyle factors and ensuring adequate calcium and vitamin D intake are important in preventing and treating osteoporosis. Pharmacological treatments are recommended for patients with a minimal trauma fracture, for those aged 70 years or over with a T-score of –3.0 or lower, or for those who are currently taking prolonged high dose corticosteroids and who have a T-score of –1.5 or lower. Bisphosphonates are recommended as first line therapy for established postmenopausal osteoporosis. Medicine selection is guided by patient gender, menopausal status, medical and fracture history, patient preference and eligibility for government subsidy.