control (n = 70 vs n = 26) • Follow-up: • Little evidence that t

control (n = 70 vs. n = 26) • Follow-up: • Little evidence that the “usual care” group differed outside the intervention • Although outcomes are based on self-report, evidence suggests that self-report of DXA testing and bisphosphonate use is very good [49, 50] • Intervention group at higher risk, e.g.: • 87% intervention • All participating pharmacists had training or certification in research participation   a. Female (74% vs. 58%)

• 73% control   b. Fracture history (30% vs. 12%) Yuksel et al. [36] Low Low Low Low • Intervention group had significantly more participants with family history of OP (47% vs. 34%) • Attrition: n = 26 (20%) in intervention and n = 23 (17%) in control • All participating pharmacists received training • Self-report confirmed by DXA report from physician (test performed) and pharmacy records

(prescription dispensed) • However, analyses adjusted for age, sex, and family history of OP • However, all were accounted Savolitinib mw for in the analyses (intention to treat analysis) • Control (“usual care”) group also given educational material, and thus, the effect may be larger than what was see more observed in the trial when compared to true “usual care” Low risk of bias means that there is little evidence that this type of bias impacted study results. High risk of bias means that some evidence indicates that this type of bias may have impacted study results BMD bone mineral density group (peripheral DXA), DXA dual-energy X-ray absorptiometry, OP osteoporosis aAllocation bias occurs when randomization fails such that comparison groups differ on important AMN-107 clinical trial prognostic variables bAttrition bias may occur if patients who continue to be followed are systematically different from those who are lost mafosfamide to follow-up in ways that effect outcomes

cPerformance bias results from differences in the provision of care between comparison groups other than differences that relate to the main intervention dDetection bias results from differential outcome assessment between comparison groups 1. Cluster RCT in Australia Crockett et al. completed a cluster RCT in New South Wales, Australia whereby all 86 community pharmacists in six suburb and six rural communities were invited to participate [34]. Of the pharmacists that were willing and had suitable space and staffing to participate, one pharmacist within each of the six suburban and six rural areas was randomly selected for participation. Each of the 12 randomly selected pharmacists was then randomized into one of two groups: (1) non-BMD group, pharmacists offered education, counseling, and risk assessment based on patient questionnaire responses only and (2) BMD group, pharmacists offered education, counseling, and risk assessment based on questionnaire responses and forearm BMD test results. The forearm BMD tests were performed by a radiographer using peripheral dual-energy X-ray absorptiometry (DXA).

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