SynthesisAge and ageing2025
Initiation of anti-osteoporosis medication following hip fracture in older adults: a systematic review and thematic synthesis of qualitative studies from patient and healthcare professional perspectives.
Synthesis in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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Who cites it
1 citing paper in PubMed.
- Prescribing of Medication to Prevent Glucocorticoid Harms in Patients With Polymyalgia Rheumatica: A Cross-Sectional Study and Two Emulated Target Trials in the Clinical Practice Research Datalink Aurum.Arthritis & rheumatology (Hoboken, N.J.) · 2026Observational
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPharmacological osteoporosis treatment is recommended for secondary fracture prevention in older patients following a hip fracture. However, not all eligible patients receive anti-osteoporosis medication (AOMs). Understanding the decision-making process regarding treatment initiation at patient level may help explain low prescription rates and offer novel solutions beyond organisational initiatives.
objectiveThis systematic review aimed to synthesise data from qualitative studies on the initiation of AOMs after a hip fracture in old age, to (i) explore the experiences and preferences of patients and healthcare professionals in the decision-making process, and (ii) clarify if this explains low prescription rates.
methodsA systematic search in seven medical databases identified qualitative publications on the initiation of AOMs in older hip fracture patients. Thematic synthesis was applied, with the CASP checklist and GRADE-CERQual approach enhancing review's rigour.
resultsTwenty studies were included, revealing two main themes with eight subthemes. The 'addressing' step illustrates that addressing osteoporosis treatment is not self-evident and depends on specialty-specific responsibilities, knowledge and capability, commitment to identifying eligible patients, and the perceived importance and feasibility of treatment. The 'discussing' step highlights the need for patient education, patient perceptiveness, making sense, a patient-centred approach, and patient choice, indicating that discussing treatment is not a clear-cut path.
conclusionsAOM initiation after hip fracture in old age is shaped by a two-step decision-making process of (i) addressing treatment and (ii) discussing treatment-which may partly explain low prescription rates. Beyond organisational strategies, promoting education and awareness may strengthen professional initiative and patient engagement.
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