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Clinical and demographic factors determining patient fracture risk decision point (FRDP) : The improving risk communication in osteoporosis (RICO) project
Sharma, Mitali Beaudart, Charlotte Clark, Patricia Fujiwara, Saeko Adachi, Jonathan D. Papaioannou, Alexandra Messina, Osvaldo D. Morin, Suzanne N. Kohlmeier, Lynn Nogues, Xavier
Sharma, Mitali
Beaudart, Charlotte
Clark, Patricia
Fujiwara, Saeko
Adachi, Jonathan D.
Papaioannou, Alexandra
Messina, Osvaldo D.
Morin, Suzanne N.
Kohlmeier, Lynn
Nogues, Xavier
Abstract
Summary
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.
Methods
In 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.
Results
In 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).
Conclusions
Most 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.
Keywords
Fracture Risk Decision Point (FRDP), FRAX® probability, osteoporosis, patient willingness to accept treatment, treatment threshold
Date
2025
Type
Journal article
Journal
Osteoporosis International
Book
Volume
36
Issue
1
Page Range
71-80
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as ‘gold’ (paid) open access
License
CC BY-NC 4.0
File Access
Open
Notes
© The Author(s) 2024.
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