Osteoporosis is a common bone disease that affects about 2 million individuals in Canada. It
affects 1 in 3 women over the age of 50, and at least 1 in 5 men in the same age range.
Osteoporosis is known as the silent disease due to its asymptomatic nature. The end result of
osteoporosis is a fragility fracture. A fragility fracture is a low trauma fracture or a fracture that
would not have normally occurred at a standing height. Due to the disease’s asymptomatic
nature, patients who have osteoporosis may not know they have osteoporosis until a fracture
has occurred. These fragility fractures are debilitating to both the patient and the economy.
Consequences, to the patient includes increase morbidity and mortality. A common site for
fragility fracture is at the hip and is considered the most serious osteoporosis fracture, most
probably necessitates hospitalization. Studies have shown that up to 20% of patients die in
the first year following a hip fracture and less than half of survivors regain the level of function
that they had prior to the hip fracture.
Despite an advancement in the diagnosis of osteoporosis, publication of clinical practice
guidelines, development of screening and fracture risk assessment tools, and interventions to
reduce the risk of fractures, only a minority of men and women with a high fracture risk receive
treatment. This may be due to healthcare professionals’ disinterest in initiating treatment for
osteoporosis, their lack of knowledge, or a lack of awareness among the public of
osteoporosis. Undermanaged osteoporosis incurs significant costs to primary and secondary
care. As such, early detection, and treatment of patients at risk are critical. Preventative
measures at the community level are also urgently needed.

Pharmacists can play an important role in narrowing gaps in osteoporosis diagnosis and
treatment adherence. Firstly, pharmacists may help identify high-risk patients, such as those
on chronic glucocorticoid therapy who can then be targeted for bone mineral density (BMD)
testing and treatment initiation. Secondly, pharmacists can provide counseling and educate
patients on medication use, fall prevention, and the importance of calcium, vitamin D, exercise,
and adherence to therapy. Pharmacists can also help identify and manage the risk factors for osteoporosis and provide counseling on nutrition and lifestyle relevant to bone health.

Pharmacists are uniquely positioned to help close the clinical care gap related to osteoporosis
diagnosis and subsequent treatment that currently exists.