Bisphosphonates are the first-choice treatment for osteoporosis. Theyeffectively increase bone mineral density, reduce markers of boneresorption, and lower the incidence of new fractures in patientswith osteoporosis-related fracture. However, the efficacy observedin clinical trials may not be realized in a real-life setting, partlydue to poor adherence to therapy, with a significant worsening ofclinical outcomes. Several issues contribute to poor adherence toosteoporosis medication, including inconvenient dosing regimens andconcerns about possible adverse events. Although strategies to improveadherence have been investigated, new approaches are required.