Evidence map›Paper›PMID 29043392›Full record

SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018

Complex interventions can increase osteoporosis investigations and treatment: a systematic review and meta-analysis.

M Kastner, L Perrier, S E P Munce, C C Adhihetty, A Lau, J Hamid, V Treister, J Chan, Y Lai, S E Straus

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 3 pooled it
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 30 citations in OpenAlex.

  1. Education intervention for older adults with osteoporosis: a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Pooled it
  2. Interventions to improve osteoporosis care: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Pooled it
  3. Pooled it
  4. Sentinel fracture: the necessity of improved post-fracture care.Wiener medizinische Wochenschrift (1946) · 2025
    Review
  5. Article
  6. Article
  7. Review
  8. Racial and Ethnic Disparities in Bone Health and Outcomes in the United States.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2021
    Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Higher rates of osteoporosis treatment initiation and persistence in patients with newly diagnosed vertebral fracture when introduced in inpatients than later in outpatients.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019
    Article
  14. Article
  15. Joint diseases: from connexins to gap junctions.Nature reviews. Rheumatology · 2017
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

M KastnerLi Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada. monika.kastner@utoronto.ca.ORCID 0000-0002-2838-7417
L PerrierGerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada.
S E P MunceToronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
C C AdhihettyInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
A LauFaculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
J HamidLi Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
V TreisterLi Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
J ChanLi Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Y LaiLi Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
S E StrausLi Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
St. Michael's Hospital · CAUniversity of Toronto · CAUniversity Health Network · CA

Funding

CIHR
6 · The paper itself

Abstract

Osteoporosis is affecting over 200 million people worldwide. Despite available guidelines, care for these patients remains sub-optimal. We developed an osteoporosis tool to address the multiple dimensions of chronic disease management. Findings from its evaluation showed a significant increase from baseline in osteoporosis investigations and treatment, so we are revising this tool to include multiple chronic conditions including an update of evidence about osteoporosis. Our objectives were to conduct a systematic review of osteoporosis interventions in adults at risk for osteoporosis. We searched bibliometric databases for randomized controlled trials (RCTs) in any language evaluating osteoporosis disease management interventions in adults at risk for osteoporosis. Reviewer pairs independently screened citations and full-text articles, extracted data, and assessed risk of bias. Analysis included random effects meta-analysis. Primary outcomes were osteoporosis investigations and treatment, and fragility fractures. Fifty-five RCTs and one companion report were included in the analysis representing 165,703 patients. Our findings from 55 RCTs and 18 sub-group meta-analyses showed that complex implementation interventions with multiple components consisting of at least education + feedback + follow-up significantly increased the initiation of osteoporosis medications, and interventions with at least education + follow-up significantly increased the initiation of osteoporosis investigations. No significant impact was found for any type of intervention to reduce fracture. Complex interventions that include at least education + follow-up or feedback have the most potential for increasing osteoporosis investigations and treatment. Patient education appears to be an important component in osteoporosis disease management.

Indexed as

Bone DensityBone Density Conservation AgentsDisease ManagementDrug UtilizationHumansOsteoporosisOsteoporotic FracturesPatient Education as TopicBone Density Conservation AgentsChronic disease managementComplex interventionsMeta-analysisOsteoporosisSystematic review

Identifiers

PMID29043392
OpenAlexW2766792507

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.