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

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 h...

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Autores: Sharma, Mitali, Beaudart, Charlotte, Clark, Patricia, Fujiwara, Saeko, Adachi, Jonathan D., Papaioannou, Alexandra, Messina, Osvaldo D., Morin, Suzanne N., Kohlmeier, Lynn, Nogués Solán, Xavier, Leckie, Carolyn, Harvey, Nicholas C., Kanis, John A., Reginster, Jean-Yves, Hiligsmann, Mickaël, Silverman, Stuart L.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/72546
Acceso en línea:https://hdl.handle.net/10230/72546
http://dx.doi.org/10.1007/s00198-024-07264-5
Access Level:acceso abierto
Palabra clave:FRAX® probability
Fracture Risk Decision Point (FRDP)
Osteoporosis
Patient willingness to accept treatment
Treatment threshold
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spelling Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) projectSharma, MitaliBeaudart, CharlotteClark, PatriciaFujiwara, SaekoAdachi, Jonathan D.Papaioannou, AlexandraMessina, Osvaldo D.Morin, Suzanne N.Kohlmeier, LynnNogués Solán, XavierLeckie, CarolynHarvey, Nicholas C.Kanis, John A.Reginster, Jean-YvesHiligsmann, MickaëlSilverman, Stuart L.FRAX® probabilityFracture Risk Decision Point (FRDP)OsteoporosisPatient willingness to accept treatmentTreatment thresholdThis 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.Springer2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/72546http://dx.doi.org/10.1007/s00198-024-07264-5reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésOsteoporosis International. 2025;36(1):71-80© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/725462026-06-12T07:21:37Z
dc.title.none.fl_str_mv Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
title Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
spellingShingle Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
Sharma, Mitali
FRAX® probability
Fracture Risk Decision Point (FRDP)
Osteoporosis
Patient willingness to accept treatment
Treatment threshold
title_short Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
title_full Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
title_fullStr Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
title_full_unstemmed Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
title_sort Clinical and demographic factors determining patient fracture risk decision point (FRDP): the improving risk communication in osteoporosis (RICO) project
dc.creator.none.fl_str_mv Sharma, Mitali
Beaudart, Charlotte
Clark, Patricia
Fujiwara, Saeko
Adachi, Jonathan D.
Papaioannou, Alexandra
Messina, Osvaldo D.
Morin, Suzanne N.
Kohlmeier, Lynn
Nogués Solán, Xavier
Leckie, Carolyn
Harvey, Nicholas C.
Kanis, John A.
Reginster, Jean-Yves
Hiligsmann, Mickaël
Silverman, Stuart L.
author Sharma, Mitali
author_facet Sharma, Mitali
Beaudart, Charlotte
Clark, Patricia
Fujiwara, Saeko
Adachi, Jonathan D.
Papaioannou, Alexandra
Messina, Osvaldo D.
Morin, Suzanne N.
Kohlmeier, Lynn
Nogués Solán, Xavier
Leckie, Carolyn
Harvey, Nicholas C.
Kanis, John A.
Reginster, Jean-Yves
Hiligsmann, Mickaël
Silverman, Stuart L.
author_role author
author2 Beaudart, Charlotte
Clark, Patricia
Fujiwara, Saeko
Adachi, Jonathan D.
Papaioannou, Alexandra
Messina, Osvaldo D.
Morin, Suzanne N.
Kohlmeier, Lynn
Nogués Solán, Xavier
Leckie, Carolyn
Harvey, Nicholas C.
Kanis, John A.
Reginster, Jean-Yves
Hiligsmann, Mickaël
Silverman, Stuart L.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv FRAX® probability
Fracture Risk Decision Point (FRDP)
Osteoporosis
Patient willingness to accept treatment
Treatment threshold
topic FRAX® probability
Fracture Risk Decision Point (FRDP)
Osteoporosis
Patient willingness to accept treatment
Treatment threshold
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/72546
http://dx.doi.org/10.1007/s00198-024-07264-5
url https://hdl.handle.net/10230/72546
http://dx.doi.org/10.1007/s00198-024-07264-5
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Osteoporosis International. 2025;36(1):71-80
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Springer
publisher.none.fl_str_mv Springer
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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