Patient discussions

Patients should be advised to accommodate total daily calcium (dietary and oral supplements) and vitamin D intake accounting for their age and menopausal status. Daily physical activity should be encouraged.

In addition, patients should be advised to lower salt intake, maintain adequate dietary protein, and increase intake of fruits and vegetables. The latter measures will help to lower urinary calcium loss and maintain bone mass. Provide patients with counseling and treatment for tobacco cessation and cessation of excessive alcohol use.

Effective fracture risk reduction in patients with osteoporosis requires long-term management, but adherence to pharmacotherapy and lifestyle changes is often low.[81][219]​​ Before starting treatment, discuss the patient’s values and preferences, and address the expected risks and benefits of treatment to support shared decision-making.[220][221]​ Regularly reassess patient satisfaction, adherence, and concerns with therapy.[62]

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