ArticleThe Journal of rheumatology2014
Patient perceptions of osteoporosis treatment thresholds.
Article in The Journal of rheumatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Recommendations on screening for primary prevention of fragility fractures.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Guideline
- Pooled it
- A pilot randomized controlled trial of a decision aid with tailored fracture risk tool delivered via a patient portal.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Trial
- Osteoporosis testing and treatment remain low in both Traditional Medicare and Medicare Advantage.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Balancing fracture risk versus risk of mortality before fracture among women aged 80 years or older.Journal of the American Geriatrics Society · 2024Article
- Article
- Current situation of shared decision making in osteoporosis: A comprehensive literature review of patient decision aids and decision drivers.Health science reports · 2022Article
- Preventive drugs for Huntington's disease: A choice-based conjoint survey of patient preferences.Journal of clinical and translational science · 2022Article
- Pharmacotherapy decisions among postmenopausal women attending a group medical consultation or a one-on-one specialist consultation at an osteoporosis center: an observational cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Observational
- Screening to prevent fragility fractures among adults 40 years and older in primary care: protocol for a systematic review.Systematic reviews · 2019Article
- Preventive Treatments for Rheumatoid Arthritis: Issues Regarding Patient Preferences.Current rheumatology reports · 2016Review
- Disparities in osteoporosis treatments.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
objectiveMany older patients express concerns about medication risks, and have higher risk thresholds than physicians for cardiovascular preventive medications. We hypothesized that patients have relatively high risk thresholds for fracture preventive medications.
methodsWomen ≥ 60 years old were recruited from 3 primary care internal medicine clinics in Wisconsin. Participants were provided information regarding fracture risks and treatment risks and benefits, followed by a series of vignettes depicting a 70-year-old woman at baseline fracture risks between 5-50%. Fracture risks were shown graphically and treatment side effects were provided for each vignette, and participants were asked to respond regarding whether they would accept treatment. The association of vignette treatment acceptance with participant beliefs regarding medication risks was examined in analyses adjusted for perceived risk of medications, patient numeracy, and prior respondent experience with osteoporosis.
resultsThe mean age of women in the cohort was 69.4 years (SD 7.29). Ninety-one percent were non-Hispanic whites, 34% reported a history of fracture, and 20.3% a history of osteoporosis. Subjects varied substantially in their responses to vignettes, but only 51% reported they would accept prescription osteoporosis treatment at the threshold currently recommended by national physician treatment guidelines, and fewer would accept treatment at lower risks. Belief that medications are generally not worth their risks was associated with lower acceptance of treatment at all levels of fracture risk.
conclusionThere is substantial variability in preferences for postmenopausal osteoporosis treatment. Presentation of individualized fracture risks as recommended by current guidelines has potential to allow better targeting to higher-risk patients, but further work is needed regarding how to present this information and counsel patients.
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