Osteoporosis treatment decision puzzle.

Cracking the Bone Code: Why Osteoporosis Meds Aren't Always the Answer

Jordan Keane in Health & Wellness December 2025 • 3 min read.

"Uncover the Hidden Reasons Behind Medication Hesitancy and How to Make Informed Choices for Bone Health"

When it comes to osteoporosis, the path to treatment isn't always straightforward. Medication decision-making is a complex process. It involves multiple considerations beyond just a doctor's prescription.

This decision starts with whether to take the medication and continues throughout care. Primary adherence determines the decision to start a medication, and secondary adherence concerns the decision to stop.

Many patients do not start osteoporosis medication, even with a high risk of fractures. Studies show only a percentage of high-risk individuals take the medication prescribed. Even when cost isn't an issue, a significant number of people never fill their prescriptions.

Decoding the Risk Perception Puzzle

Patients weigh the perceived risks against the perceived benefits when deciding about medications. Although risk involves outcome probability, individuals interpret it uniquely.

Perception influences the patient's assessment of medication attributes such as cost, convenience, efficacy, and side effects. These effects include effects already experienced or are only perceived.

Information Sources: Doctor, pharmacist, media.
Immediacy: How recently you heard it.
Biases: Preconceived notions.
Framing: The way information is presented.
Emotions: Feelings about the medication or condition.
Denial: Refusal to accept the risk.
Disease Perception: How you view osteoporosis.

New risks like osteonecrosis of the jaw (ONJ) stand out. Sensational or catastrophic side effects are easily remembered. Risks receive heightened attention in the media, unlike positive news about fracture reduction.

Empowering Informed Choices for Bone Health

Better results will come with greater understanding. Individuals need to appreciate the real risks of NOT taking medication, compared to the perceived side effects. The path forward involves open communication and patient education.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1007/s11914-018-0494-0, Alternate LINK

Title: Medication Decision-Making In Osteoporosis: Can We Explain Why Patients Do Not Take Their Osteoporosis Medications?

Subject: Endocrinology, Diabetes and Metabolism

Journal: Current Osteoporosis Reports

Publisher: Springer Science and Business Media LLC

Authors: Stuart Silverman, Deborah T. Gold

Published: 2018-10-29

Everything You Need To Know

What does primary adherence mean when we're talking about osteoporosis medication?

Primary adherence refers to the initial decision of whether to start taking osteoporosis medication as prescribed. It's a crucial first step because many individuals, even those at high risk of fractures, do not begin their medication regimen. Factors influencing primary adherence include risk perception, how individuals weigh the perceived risks against the perceived benefits of the medication, and various cognitive, emotional, and informational factors.

What is secondary adherence and why is it so important for osteoporosis treatment?

Secondary adherence is the decision to continue or stop taking osteoporosis medication after the treatment has already started. It's significant because consistent use of medication is necessary to get the most benefits, like reducing the risk of fractures. Reasons for stopping can include experiencing or fearing side effects, cost concerns, or a change in how one perceives the disease or its risks.

What is risk perception, and how does it affect decisions about taking medication for osteoporosis?

Risk perception is how individuals subjectively evaluate the potential risks and benefits of taking osteoporosis medication. This perception is influenced by factors like information sources (doctors, media), immediacy (how recently information was received), biases, framing (how information is presented), emotions, denial, and disease perception. Sensationalized or catastrophic side effects, such as osteonecrosis of the jaw (ONJ), can disproportionately influence risk perception and lead to medication hesitancy.

What are some of the key things that shape how someone perceives the risks of osteoporosis medication?

Several elements can strongly affect someone's perception of medication risks for osteoporosis. Information sources, such as doctors, pharmacists, and the media, play a crucial role. How recently you heard the information (immediacy), any preconceived notions (biases), the way information is presented (framing), your feelings about the medication or condition (emotions), a refusal to accept the risk (denial), and how you view osteoporosis itself (disease perception) can all significantly influence your perception.

How can people make better, more informed choices about osteoporosis medication?

Open communication between patients and healthcare providers is crucial. Patients need to understand the real risks of not taking medication for osteoporosis and weigh them against any perceived side effects. Patient education can empower individuals to make informed choices about their bone health and improve adherence to medication regimens, ultimately reducing the risk of fractures.