Evidence map›Paper›PMID 39969705›Full record

ArticleArchives of osteoporosis2025

The association between the number of chronic conditions and treatment of patients who are at high risk for future fracture in the Ontario Fracture Screening and Prevention Program (FSPP).

Anum Ali, Ella Huszti, Shahryar Noordin, Earl Bogoch, Alan Yang, Ravi Jain, Jennifer Weldon, Joanna E M Sale

Abstract read
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Article in Archives of osteoporosis, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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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

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Anum AliInstitute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor- 155 College Street, Toronto, ON, M5T 3M6, Canada. Anum.asifhakimali@mail.utoronto.ca.
Ella HusztiInstitute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor- 155 College Street, Toronto, ON, M5T 3M6, Canada.
Shahryar NoordinDepartment of Surgery, Aga Khan University, National Stadium Rd, P.O. Box 3500, Karachi City, Sindh, Pakistan.
Earl BogochDepartment of Surgery, University of Toronto, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W85, Canada.
Alan YangMusculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Ravi JainOsteoporosis Canada, Toronto, ON, Canada.
Jennifer WeldonOsteoporosis Canada, Toronto, ON, Canada.
Joanna E M SaleInstitute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor- 155 College Street, Toronto, ON, M5T 3M6, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We compared medication prescription and initiation proportions among high-risk Fracture Screening and Prevention Program patients with multiple chronic conditions. Patients with two conditions were more likely to receive prescriptions and initiate prescribed medication than those with none. Post hoc analysis showed that patients with ≥ 3 conditions were less likely to be prescribed and to initiate medication, compared to those with two conditions. Tailored interventions are important for improving post-fracture care outcomes. PURPOSE: To investigate the association between the number of chronic conditions and pharmacological treatment outcomes in high-risk patients who were screened through the Fracture Screening and Prevention Program (FSPP).

methodsA retrospective cohort study was employed to determine the association between the number of chronic conditions and treatment outcomes. All high-risk patients who were enrolled in the FSPP between June 1, 2017, and June 30, 2022, were included in the study. The number of self-reported chronic conditions available in the FSPP data was classified into four categories: (1) 0 condition; (2) 1 condition; (3) 2 conditions; and (4) ≥ 3 conditions. Multivariable logistic regression models were created with prescription and initiation as outcomes.

resultsIn total, 11,245 patients were identified as high-risk for future fracture. Patients with two chronic conditions demonstrated a 26% higher odds of receiving a medication prescription, and those with two chronic conditions and prescribed bone-active medication had a 57% increased odds of initiating the treatment compared to individuals without chronic conditions. No significant differences in medication prescription or initiation were seen in those with 1 or ≥ 3 chronic conditions compared to those without chronic conditions. In post hoc testing, we saw a 25-30% significantly lower odds of medication prescription and initiation in patients reporting ≥ 3 chronic conditions when compared to those who reported only two chronic conditions.

conclusionThe findings suggest that a large provincial secondary fracture prevention program resulted in higher odds of prescription and initiation of treatment in patients with two chronic conditions compared to those having no chronic conditions. Potential inequities in these treatment outcomes were found with a threshold of three or more chronic conditions. This highlights the need for tailored interventions and comprehensive support systems to improve fracture prevention outcomes for high-risk patients with multiple chronic conditions.

Indexed as

Bone Density Conservation AgentsOsteoporotic FracturesAgedAged, 80 and overChronic DiseaseFemaleHumansMaleMiddle AgedOntarioRetrospective StudiesRisk FactorsBone Density Conservation AgentsFracture Liaison ServiceFracture Screening and Prevention Program (FSPP)Fragility fracturesMultiple chronic conditionsTreatment

Identifiers

PMID39969705

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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.