Evidence map›Paper›PMID 38898212›Full record

ArticleArchives of osteoporosis2024

Exploring practice and perspectives on shared decision-making about osteoporosis medicines in Fracture Liaison Services: the iFraP development qualitative study.

Laurna Bullock, Fay Manning, Ashley Hawarden, Jane Fleming, Sarah Leyland, Emma M Clark, Simon Thomas, Christopher Gidlow, Cynthia P Iglesias-Urrutia, Joanne Protheroe and 6 more

Abstract read
In one paragraph

Article in Archives of osteoporosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Impact of a national reimbursement add-on policy on refracture risk and secondary fracture prevention after hip fracture in Japan: a population-based interrupted time series analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
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  3. Review
  4. Article
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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

16 authors.

Laurna BullockCentre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, UK. l.bullock@keele.ac.uk.ORCID 0000-0002-4193-1835
Fay ManningUniversity of Exeter Medical School, Devon, UK.ORCID 0000-0002-9768-1695
Ashley HawardenCentre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, UK.ORCID 0000-0002-5462-579X
Jane FlemingCambridge Public Health, University of Cambridge, Cambridge, UK.
Sarah LeylandRoyal Osteoporosis Society, Bath, UK.
Emma M ClarkBristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, UK.
Simon ThomasPrescribing Decision Support Ltd and School of Pharmacy and Bioengineering, Keele University, Staffordshire, UK.
Christopher GidlowCentre for Health and Development, Staffordshire University, Stoke-On-Trent, Staffordshire, UK.
Cynthia P Iglesias-UrrutiaDepartment of Health Sciences, University of York, York, UK.
Joanne ProtheroeCentre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, UK.ORCID 0000-0002-9608-1487
Janet LefroyCentre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, UK.ORCID 0000-0002-2662-1919
Sarah RyanHaywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Stoke-On-Trent, Staffordshire, UK.
Terence W O'NeillCentre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK.
Christian MallenCentre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, UK.
Clare JinksCentre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, UK.ORCID 0000-0002-3407-2446
Zoe PaskinsCentre for Musculoskeletal Health Research, School of Medicine, Keele University, Staffordshire, UK.ORCID 0000-0002-7783-2986

Funding

National Institute for Health and Care Research CS-2018-18-ST2-010Royal Osteoporosis Society 430
6 · The paper itself

Abstract

Interviews and focus groups with patients, FLS clinicians, and GPs identified challenges relating to clinical and shared decision-making about bone health and osteoporosis medicines. Findings will inform the development of the multicomponent iFraP intervention to address identified training needs and barriers to implementation to facilitate SDM about osteoporosis medicines. PURPOSE: The iFraP (improving uptake of Fracture Prevention treatments) study aimed to develop a multicomponent intervention, including an osteoporosis decision support tool (DST), to support shared decision-making (SDM) about osteoporosis medicines. To inform iFraP intervention development, this qualitative study explored current practice in relation to communication about bone health and osteoporosis medicines, anticipated barriers to, and facilitators of, an osteoporosis DST, and perceived training needs.

methodsPatients attending an FLS consultation (n = 8), FLS clinicians (n = 9), and general practitioners (GPs; n = 7) were purposively sampled to participate in a focus group and/or telephone interview. Data were transcribed, inductively coded, and then mapped to the Theoretical Domains Framework (TDF) as a deductive framework to systematically identify possible barriers to, and facilitators of, implementing a DST.

resultsInductive codes were deductively mapped to 12 TDF domains. FLS clinicians were perceived to have specialist expertise (knowledge). However, clinicians described aspects of clinical decision-making and risk communication as difficult (cognitive skills). Patients reflected on decisional uncertainty about medicines (decision processes). Discussions about current practice and the proposed DST indicated opportunities to facilitate SDM, if identified training needs are met. Potential individual and system-level barriers to implementation were identified, such as differences in FLS configuration and a move to remote consulting (environmental context and resources).

conclusionsUnderstanding of current practice revealed unmet training needs, indicating that using a DST in isolation would be unlikely to produce a sustained shift to SDM. Findings will shape iFraP intervention development to address unmet needs.

Indexed as

Bone Density Conservation AgentsDecision Making, SharedFocus GroupsOsteoporosisQualitative ResearchAgedFemaleHumansMaleMiddle AgedOsteoporotic FracturesBone Density Conservation AgentsConsultationFracture Liaison ServicesiFraPIntervention developmentOsteoporosisQualitativeShared decision-making

Identifiers

PMID38898212
PMCPMC11186902

What OpenQuestion holds

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LicenceCC BY
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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.