RT Journal Article
SR Electronic
T1 Randomised trial assessing the impact of framing of fracture risk and osteoporosis treatment benefits in patients undergoing bone densitometry
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e013703
DO 10.1136/bmjopen-2016-013703
VO 7
IS 2
A1 Rama Kalluru
A1 Keith J Petrie
A1 Andrew Grey
A1 Zaynah Nisa
A1 Anne M Horne
A1 Greg D Gamble
A1 Mark J Bolland
YR 2017
UL http://bmjopen.bmj.com/content/7/2/e013703.abstract
AB Objectives The accuracy of patients' perception of risk is important for decisions about treatment in many diseases. We framed the risk of fracture and benefits of treatment in different ways and assessed the impact on patients' perception of fracture risk and intentions to take medication.Design Randomised trial of 4 different presentations of fracture risk and likely benefits from osteoporosis treatment.Setting Academic centre.Participants 200 patients undergoing bone densitometry.Intervention Presentation that framed the patient's absolute fracture risk either as the chance of having or not having an event, with their likely benefits from osteoporosis treatment in natural frequencies or numbers needed to treat.Outcomes Participants' views about their fracture risk and the need for osteoporosis treatment.Results The median 5-year fracture risk threshold participants regarded as high enough to consider preventative medication was 50–60%, and did not change substantially after the presentation. The median (Q1, Q3) 5-year risk initially estimated by participants was 20% (10, 50) for any fracture and 19% (10, 40) for hip fracture. 61% considered their fracture risk was low or very low, and 59–67% considered their fracture risk was lower than average. These participant estimates were 2–3 times higher than Garvan calculator estimates for any fracture, and 10–20 times higher for hip fracture. Participant estimates of fracture risk halved after the presentation, but remained higher than the Garvan estimates (1.5–2 times for any fracture, 5–10 times for hip fracture). There was no difference in these outcomes between the randomised groups. Participants' intentions about taking medication to prevent fractures were not substantially affected by receiving information about fracture risk and treatment benefits.Conclusions Altering the framing of estimated fracture risks and treatment benefits had little effect on participants' perception of the need to take treatment or their individual fracture risk.Trial registration number ACTRN12613001081707; Pre-results.