Effective Risk Communication and Improving Adherence

Adherence to osteoporosis medications often remains suboptimal, with numerous patients not filling their scripts, not appropriately taking their medicines or discontinuing therapies earlier than expected. Very strong relationships between quality of communication provided by clinicians and final adherence to treatments have been highlighted in the literature. Indeed, one factor that can influence the decision of an individual patient to take an osteoporosis medication or to adhere to an existing medication plan is the patient's understanding of their individual health risk and fracture risk. Hence effective communication between the healthcare professional and patient is an important aspect of patient-centred care. Different factors are involved in the quality of health risk and fracture risk communication: the way the information is presented by clinicians, the capacity of the clinicians to adapt their language to the patient they have in from of them, the relationship between clinicians and patients, including the way the information is understood by patients, the self-perception and understanding by patients of their own disease, their perspective in regards of their own health, their health literacy, their numeracy, their own emotions and experiences. In this chapter we will first try to understand and interpret factors involved in adherence or persistence to medication and positive bone health behaviours and, second, to understand the complexities of the communication of risk to an individual. Recommendations to improve effective communication of risk from healthcare professionals to patients are provided.