Evidence map›Paper›PMID 39875677›Full record

Trial reportArchives of osteoporosis2025

Addressing healthcare disparities and improving osteoporosis management in rural communities: a cluster randomized control trial.

Shau-Huai Fu, Wei-Jhen Lai, Hung-Kuan Yen, Shikha Kukreti, Chung-Yi Li, Chih-Chien Hung, Chen-Yu Wang

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

Trial report in Archives of osteoporosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05104034 (Comprehensive Risk Assessment and Prevention Plan of Osteoporosis and Sarcopenia for the Elderly Participating in Community-based Long-term Care Services), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT05104034 naunknown statusnot on this map

Comprehensive Risk Assessment and Prevention Plan of Osteoporosis and Sarcopenia for the Elderly Participating in Community-based Long-term Care Services

TypeinterventionalSponsorNational Taiwan University HospitalRan2021 to 2025Enrolled600ConditionsOsteoporosis, Sarcopenia, FrailtyArmsOsteoporosis screening and treatment as needed, Sarcopenia, Exercise, Nutrition, Pharmaceutical care
3 · Its place in the literature

Who cites it

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

  1. Pooled it
  2. 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

7 authors.

Shau-Huai Fu *Department of Orthopedics, National Taiwan University Hospital Yun-Lin Branch, Douliu, Taiwan.ORCID 0000-0001-9853-872X
Wei-Jhen Lai *Department of Education, China Medical University Hospital, Taichung, Taiwan.ORCID 0009-0002-1660-9016
Hung-Kuan YenDepartment of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan.ORCID 0000-0003-4381-2220
Shikha KukretiDepartment of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-8370-3988
Chung-Yi LiDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-0321-8908
Chih-Chien Hung *Department of Orthopedics, National Taiwan University Hospital Yun-Lin Branch, Douliu, Taiwan. btoaew@gmail.com.ORCID 0000-0001-6523-9520
Chen-Yu Wang *Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan. valinawang0220@nhri.edu.tw.ORCID 0000-0003-0498-2438

Funding

National Health Research Institutes CG-111- GP-05National Health Research Institutes NHRI-11A1-CG-CO-02-2225-1National Taiwan University Hospital Yunlin Branch NTUHYL112.F009National Taiwan University Hospital Yunlin Branch NTUHYL112.X021
6 · The paper itself

Abstract

Rural communities face healthcare challenges. This study assessed a multicomponent intervention to improve hospital visits and anti-osteoporosis medication (AOM) treatment rates. A total of 567 patients were randomized into three groups. Results showed significant improvements in hospital attendance and AOM treatment in intervention groups compared to usual care group. PURPOSE: Rural communities face limited healthcare access, financial constraints, and transportation barriers leading to health disparities. This study examined interventions that reduced health disparities in increasing the outpatient attendance and treatment rate of anti-osteoporosis medication (AOM), while identifying factors contributing to therapy refusal in rural communities.

methodsA total of 567 patients were randomized at the community level into three groups: multicomponent integrated care (MIC), osteoporosis care only (OC), and usual care (UC). Fracture Risk Assessment Tool and dual-energy X-ray absorptiometry scans were used to evaluate the osteoporosis and osteoporotic fracture risk. High- and moderate-risk patients were advised to pursue further hospital-based assessments and treatment. Both the MIC and OC groups received five interventions to address rural barriers, including specialist access, disease education, overcoming transportation barriers, peer support, and dedicated case managers. However, UC excluded transportation assistance, peer support, and case management. Outcomes measured included outpatient attendance, AOM treatment rates, and factors affecting hospital assessment refusal, analyzed via multivariable logistic modeling.

resultsIn the MIC group, 73.3% of patients attended the outpatient clinic and 58.6% received AOM. In the OC group, 81% patients attended and 69.3% received AOM. Conversely, in the UC group, only 4.1% attended and received AOM. Significant differences in attendance and AOM rates were found between the MIC and UC groups and between the OC and UC groups (p < .001 for both). Common barriers included beliefs that treatment was unnecessary and lack of hospital access. Risk factors hindering outpatient attendance include male sex, low education, low budget, multiple disabilities, and osteopenia diagnosis.

conclusionAddressing transportation barriers and implementing dedicated case management are crucial for improving healthcare access among rural patients.

trial registrationClinicalTrials.gov NCT05104034.

Indexed as

Healthcare DisparitiesOsteoporosisRural PopulationAgedAged, 80 and overBone Density Conservation AgentsFemaleHealth Services AccessibilityHumansMaleMiddle AgedOsteoporotic FracturesBone Density Conservation AgentsHealthcare disparitiesMulticomponent interventionOsteoporosis interventionRural healthcare access

Identifiers

PMID39875677

What OpenQuestion holds

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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.