<![CDATA[Osteoporosis detection remains suboptimal in Malaysia. This study aimed to evaluate the Malaysian Osteoporosis Screening Tool (MOST) and supplementation behaviours in a community pharmacy. A cross-sectional study was conducted in a private pharmacy in Temerloh, Pahang (May–August 2025). Postmenopausal women (n = 126) completed questionnaires and underwent anthropometric assessment (BMI, hip circumference). MOST scores were calculated, and group differences were analyzed using Mann–Whitney U and Kruskal–Wallis tests (p < 0.05). All participants were classified as "at risk" (MOST ≥ 4); the median score was 42.0 (IQR 12.0–42.0). Scores were significantly higher among women aged ≥60 years (p < 0.001), those with lower education (p = 0.005), and the unemployed (p = 0.005), but were unrelated to income, ethnicity, or residence. Hip circumference was ≥90 cm in 96.8% of cases, limiting its discriminatory value. Lifestyle and clinical factors, including family history, hormone therapy, steroid use, smoking, coffee intake, carbonated drinks, and calcium- and vitamin D-rich foods, were not associated with MOST scores. Supplement use included calcium (27.8%), vitamin D (35.7%), and combined calcium–vitamin D (26.2%). Calcium users had higher scores (p = 0.011); vitamin D or combined use showed no differences (p > 0.05). MOST concentrated nearly all postmenopausal women into the high-risk category, primarily reflecting age and menopausal duration. Findings support its feasibility in community pharmacies and highlight gaps in coordinated calcium–vitamin D supplementation.]]>
