When do you start bisphosphonates empirically, irrespective of DEXA results, in patients going on chronic glucocorticoids?

What do you consider when starting bisphosphonates empirically in patients going on chronic glucocorticoids?

• Assess baseline risk factors (age, sex, postmenopausal, planned length of corticosteroid use, etc)
• Obtain DEXA to stratify risk
• If high risk, start treatment at same time as steroid prescription
• Start bisphosphonate early (patient has been taking steroids < 3 months)
• Consider anabolic if patient already taking steroids > 3 months
• Other