Abstract： Objective To analyze the compliance of outpatient prescription in elderly patients with osteoporosis,and to es-tablish and verify the prediction model based on the compliance of outpatient prescription in elderly patients with osteoporosis.Meth-ods Through the pre-review system of outpatient prescription of Affiliated Hospital of Guangdong Medical University,a total of 195 cases of elderly osteoporosis admitted to the hospital from January 2023 to December 2023 were collected.The treatment compliance of the patients was assessed using the Chinese revised medication compliance scale.They were divided into poor treatment compliance group(57 cases,29.23%)and good compliance group(138 cases,70.77%).57 patients in poor treatment compliance group were randomly divided into training set(45 cases)and verification set(12 cases).Univariate and multivariate logistic regression analysis were also used to analyze the factors affecting compliance,and a nomogram model predicting poor treatment compliance in patients was constructed and validated.Results Age(>75 years),education level(primary school and below),living alone,combined under-lying diseases,type of medication(>4),and irregular follow-up in the same clinic were risk factors for poor compliance in elderly pa-tients with osteoporosis after treatment with outpatient prescription drugs(P<0.05).The nomogram model validation results showed that the consistency indices of the training and validation sets were 0.803(95%CI:0.758-0.826)and 0.811(95%CI:0.761-0.823),respectively,and the calibration curves tended to be ideal curves,with AUC of 0.755(95%CI:0.714-0.811)and 0.843(95%CI:0.725-0.883),respectively.Conclusion The patient compliance prediction model based on outpatient prescription for osteoporosis in the elderly established in this study has high accuracy and reliability and can effectively predict the medication compli-ance of patients.