Evidence map›Paper›PMID 30232538›Full record

Trial reportOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2019

Adherence to osteoporosis therapy after an upper extremity fracture: a pre-specified substudy of the C-STOP randomized controlled trial.

F A McAlister, C Ye, L A Beaupre, B H Rowe, J A Johnson, D Bellerose, I Hassan, S R Majumdar

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01401556 (Comparing Strategies Targeting Osteoporosis to Prevent Recurrent Fractures), which is not on this map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
2.6field-weighted citation impact, top 12% 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.

NCT01401556 nacompletednot on this map

Comparing Strategies Targeting Osteoporosis to Prevent Recurrent Fractures: C-STOP# Randomized Trial

TypeinterventionalSponsorUniversity of AlbertaRan2012 to 2022Enrolled441ConditionsOsteoporosisArmscase management, Multifaceted quality improvement intervention
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. Implementation and operationalization of Integrated People-Centred Health Services delivery strategies in integrated osteoporosis care (IOC) initiatives: 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 · 2023
    Pooled it
  3. Pooled it
  4. Long-term adherence to anti-osteoporosis medication and determinants of adherence in the population-based screening trial ROSE.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Trial
  5. Article
  6. Review
  7. Review
  8. Supporting patients to get the best from their osteoporosis treatment: a rapid realist review of what works, for whom, and in what circumstance.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. A patient-level key performance indicator set to measure the effectiveness of fracture liaison services and guide quality improvement: a position paper of the IOF Capture the Fracture Working Group, National Osteoporosis Foundation and Fragility Fracture Network.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Article
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

8 authors at 1 institution in 1 country.

F A McAlisterDepartment of Medicine, University of Alberta, Edmonton, Canada. Finlay.McAlister@ualberta.ca.ORCID http://orcid.org/0000-0001-7435-3341
C YeDepartment of Medicine, University of Alberta, Edmonton, Canada.
L A BeaupreDepartment of Physical Therapy, University of Alberta, Edmonton, Canada.
B H RoweDepartment of Emergency Medicine, University of Alberta, Edmonton, Canada.
J A JohnsonSchool of Public Health, University of Alberta, Edmonton, Canada.
D BelleroseDepartment of Medicine, University of Alberta, Edmonton, Canada.
I HassanEPICORE Centre, Department of Medicine, University of Alberta, Edmonton, Canada.
S R MajumdarDepartment of Medicine, University of Alberta, Edmonton, Canada.
University of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite their proven efficacy for secondary fracture prevention, long-term adherence with oral bisphosphonates is poor.

introductionTo compare the effectiveness of two interventions on long-term oral bisphosphonate adherence after an upper extremity fragility fracture.

methodsCommunity-dwelling participants 50 years or older with upper extremity fragility fractures not previously treated with bisphosphonates were randomized to either a multi-faceted patient and physician educational intervention (the active control arm) vs. a nurse-led case manager (the study arm). Primary outcome was adherence (taking > 80% of prescribed doses) with prescribed oral bisphosphonates at 12 months postfracture between groups; secondary outcomes included rates of primary non-adherence and 24-month adherence. We also compared quality of life between adherent and non-adherent patients.

resultsBy 12 months, adherence with the initially prescribed bisphosphonate was similar (p = 0.96) in both groups: 38/48 (79.2%) in the educational intervention group vs. 66/83 (79.5%) in the case manager arm. By 24 months, adherence rates were 67% (32/48) in the educational intervention group vs. 53% (43/81) in case managed patients (p = 0.13). Primary non-adherence was 6% (11 patients) in the educational intervention group and 12% (21 patients) in the case managed group (p = 0.07). Prior family history of osteoporosis (aOR 2.1, 95% CI 1.0 to 4.4) and being satisfied with current medical care (aOR 2.3, 95% CI 1.1 to 4.8) were associated with better adherence while lower income (aOR 0.2, 95% CI 0.1 to 0.6, for patients with income < $30,000 per annum) was associated with poorer rates of adherence. There were no differences in health-related quality of life scores at baseline or during follow-up between patients who were adherent and those who were not.

conclusionWhile both interventions achieved higher oral bisphosphonate adherence compared to previously reported adherence rates in the general population, primary non-adherence and long-term adherence to bisphosphonates were similar in both arms. Adherence was influenced by family history of osteoporosis, satisfaction with current medical care, and income.

trial registrationClinicalTrials.gov : NCT01401556.

Indexed as

Drug MonitoringAdministration, OralAgedAlbertaBone Density Conservation AgentsCase ManagementDiphosphatesFemaleHumansMaleMiddle AgedOsteoporosisOsteoporotic FracturesPatient Education as TopicPsychometricsQuality of LifeBone Density Conservation AgentsDiphosphatesAdherenceC-STOPOsteoporosis

Identifiers

PMID30232538
OpenAlexW2891594883

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.