Evidence map›Paper›PMID 39432087›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Clinical and demographic factors determining patient fracture risk decision point (FRDP): The improving risk communication in osteoporosis (RICO) project.

Mitali Sharma, Charlotte Beaudart, Patricia Clark, Saeko Fujiwara, Jonathan D Adachi, Alexandra Papaioannou, Osvaldo D Messina, Suzanne N Morin, Lynn Kohlmeier, Xavier Nogues and 6 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Towards a socially informed fracture-prevention agenda: expanding the lens beyond epidemiology.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  2. Review
  3. 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

16 authors.

Mitali SharmaThe OMC Research Center, Beverly Hills, CA, USA. mxs2067@case.edu.ORCID http://orcid.org/0009-0003-5149-0142
Charlotte BeaudartDepartment of Health Services Research, CAPHRI Care & Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Patricia ClarkClinical Epidemiology Unit, Faculty of Medicine UNAM, Children's Hospital of Mexico Federico Gomez, Mexico City, Mexico.
Saeko FujiwaraDepartment of Pharmacy, Yasuda Women's University, Hiroshima, Japan.
Jonathan D AdachiMcMaster University, Hamilton, ON, Canada.
Alexandra PapaioannouMcMaster University, Hamilton, ON, Canada.
Osvaldo D MessinaInvestigaciones Reumatológicas y Osteológicas (IRO). Collaborating Centre WHO, Buenos Aires, Argentina.
Suzanne N MorinDepartment of Medicine, McGill University, Montreal, Canada.
Lynn KohlmeierSpokane Osteoporosis and Endocrinology, Spokane, WA, USA.
Xavier NoguesInternal Medicine Department, CIBERFES (ISCIII), Hospital del Mar Research Institute, Pompeu Fabra University, Barcelona, Spain.
Carolyn LeckieMcMaster University, Hamilton, ON, Canada.
Nicholas C HarveyMRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK.
John A KanisMary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
Jean-Yves ReginsterDivision of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium.
Mickael HiligsmannDepartment of Health Services Research, CAPHRI Care & Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Stuart L SilvermanThe OMC Research Center, Beverly Hills, CA, USA.

Funding

Medical Research Council MC_PC_21003Medical Research Council MC_UP_A620_1015Medical Research Council MC_UU_12011/2
6 · The paper itself

Abstract

This study aims to understand how osteoporosis medication acceptance varies across countries with differing guidance on treatment threshold and influence of clinical and demographic factors. A total of 79.2% accepted treatment at a fracture probability at or below the treatment threshold. Fracture history and age did not strongly impact acceptance, suggesting a need for improved fracture risk communication. PURPOSE: This part of the Improving Risk Communication in Osteoporosis (RICO) study aims to understand patients' willingness to initiate osteoporosis treatment given a hypothetical fracture probability-derived from the FRAX® Risk Assessment Tool-and how age, fracture history, and numeric literacy may influence this.

methodsIn 2022-2023, 332 postmenopausal women at risk of fracture were interviewed from nine countries to determine participants' Fracture Risk Decision Point (FRDP), the lowest probability of major osteoporotic fracture at which they would accept an osteoporosis medication. Participants' FRDP was evaluated given eight hypothetical 10-year FRAX scores.

resultsIn countries with FRAX-based treatment thresholds, over half of the participants per country reported an FRDP that was below the threshold. Collectively, 79.2% demonstrated FRDPs at or below their respective threshold. Age and fracture history did not have a strong influence on FRDP; however, those who demonstrated higher levels of numeric literacy reported a significantly higher median FRDP (10%) compared to those who showed lower levels (5%, p < 0.001).

conclusionsMost patients were willing to accept an osteoporosis medication prescription at a hypothetical FRAX probability that was even lower than that of their nationally recommended treatment threshold. Literacy scores had a significant influence on FRDP whereas age and fracture history did not.

Indexed as

Bone Density Conservation AgentsClinical Decision-MakingOsteoporotic FracturesRisk AssessmentAgedAged, 80 and overAge FactorsFemaleHealth LiteracyHumansMiddle AgedOsteoporosis, PostmenopausalPatient Acceptance of Health CareBone Density Conservation AgentsFracture Risk Decision Point (FRDP)FRAX® probabilityOsteoporosisPatient willingness to accept treatmentTreatment threshold

Identifiers

PMID39432087
PMCPMC11706902

What OpenQuestion holds

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LicenceCC BY-NC
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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.