Thirteen RCTs were included in the review (n=27,591, sample range 15 to 10,865). Study quality was generally poor.
One of three RCTs of physician reminder with or without patient risk assessment reported significantly reduced fractures (RR 0.58, 95% CI: 0.37 to 0.90) and increased osteoporosis therapy (RR 2.44, 95% CI: 1.43 to 4.17) in the intervention group compared with controls; the other two RCTs had mixed or non-statistically significant findings.
Three of eight RCTs of physician reminder plus education with or without risk assessment reported significantly increased bone marrow density testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67) in the intervention group compared with controls. All interventions targeted both physicians and patients.
The other five RCTs had mixed or non-statistically-significant findings. One of two RCTs of education with exercise or risk assessment reported statistically significant benefits in quality of life in the intervention group compared with controls (SF36 score mean difference: 8.6 to 12.0); the other RCT did not report statistically significant findings.
Other results were reported in web appendices.