{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T00:41:54Z","timestamp":1794012114763,"version":"4.8.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"ZonMw research line Rational Pharmacotherapy","award":["848016001"],"award-info":[{"award-number":["848016001"]}]},{"name":"Medical Ethics Committee","award":["METC2028-0507-A-10"],"award-info":[{"award-number":["METC2028-0507-A-10"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Shared decision-making (SDM) aims to improve patients\u2019 experiences with care, treatment adherence, and health outcomes. However, the effectiveness of SDM in patients with a recent fracture who require anti-osteoporosis medication (AOM) is unclear. The objective of this study was to assess the effectiveness of a multicomponent adherence intervention (MCAI) including a patient decision aid (PDA) and motivational interviewing at Fracture Liaison Services (FLS) on multiple outcomes compared with usual care (UC). This pre-post superiority study included patients with a recent fracture attending FLS and with AOM treatment indication. The primary outcome was 1-year AOM persistence measured by pharmacy records. Secondary outcomes included treatment initiation, AOM adherence (measured by medication possession ratio [MPR]), decision quality (SDM process; 0\u2013100, best), and decisional conflict (0\u2013100, highest conflict), subsequent fractures, and mortality. Outcomes were tested in MCAI and UC groups at the first FLS visit and 4 and 12 months afterwards. Multiple imputation and uni- and multivariable analyses were performed. Post hoc analyses assessed the role of health literacy level. In total, 245 patients (MCAI: n\u2009=\u2009136, UC: n\u2009=\u2009109) were included. AOM persistence was 80.4% in the MCAI and 76.7% in the UC group (p=.626). SDM process scores were significantly better in MCAI (60.4 vs 55.1; p = .003). AOM initiation (97.8% vs 97.5%), MPR (90.9% vs 88.3%, p=.582), and decisional conflict (21.7 vs 23.0; p = .314) did not differ between groups. Results did not change importantly after adjustment. Stratified analyses by health literacy showed a better effect on MPR and SDM in those with adequate health literacy. This study showed no significant effect on AOM persistence; however, it demonstrated a significant positive effect of MCAI on SDM process in FLS attendees. (Netherlands Trial Registry, Trial NL7236 [NTR7435]; version 1.0; 26-11-2020 https:\/\/onderzoekmetmensen.nl\/nl\/trial\/22858).<\/jats:p>","DOI":"10.1093\/jbmr\/zjae161","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T17:40:07Z","timestamp":1727718007000},"page":"1584-1595","source":"Crossref","is-referenced-by-count":4,"title":["A quasi-experimental study about shared decision-making and motivational interviewing on patients with a recent fracture attending Fracture Liaison Services"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0032-0712","authenticated-orcid":false,"given":"Lieke","family":"Maas","sequence":"first","affiliation":[{"name":"Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University , 6200 MD, Maastricht,","place":["The 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Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Bours","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , Division of Rheumatology, , 6229 HX Maastricht,","place":["The Netherlands"]},{"name":"Maastricht University Medical Center , Division of Rheumatology, , 6229 HX Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7469-3781","authenticated-orcid":false,"given":"Trudy","family":"van der Weijden","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Care and Public Health Research Institute (CAPHRI) , 6200 MD Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3984-2232","authenticated-orcid":false,"given":"Joop P","family":"van den Bergh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, VieCuri Medical Center , 5912 BL Venlo,","place":["The Netherlands"]},{"name":"Department of Internal Medicine , Division of Rheumatology, , 6229 HX Maastricht,","place":["The Netherlands"]},{"name":"Maastricht University Medical Center , Division of Rheumatology, , 6229 HX Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2643-1592","authenticated-orcid":false,"given":"Marsha","family":"van Oostwaard","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, VieCuri Medical Center , 5912 BL Venlo,","place":["The Netherlands"]},{"name":"Department of Internal Medicine , NUTRIM, , 6229 HX Maastricht,","place":["The Netherlands"]},{"name":"Maastricht University Medical Center , NUTRIM, , 6229 HX Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2796-729X","authenticated-orcid":false,"given":"Sander M J","family":"van Kuijk","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center , 6229 HX Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-9533","authenticated-orcid":false,"given":"Annelies","family":"Boonen","sequence":"additional","affiliation":[{"name":"Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University , 6200 MD, Maastricht,","place":["The Netherlands"]},{"name":"Department of Internal Medicine , Division of Rheumatology, , 6229 HX Maastricht,","place":["The Netherlands"]},{"name":"Maastricht University Medical Center , Division of Rheumatology, , 6229 HX 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