At-risk elderly denied bone scans

Only a quarter of eligible women over 75 receive osteoporosis medication in the UK.

Osteoporosis care in the UK is falling far short of national guidelines, researchers claim.

The first evaluation of nationally representative data on osteoporosis management in primary care shows that only a quarter of women aged over 75 with a prior fragility fracture have received osteoporosis medication.

Less than one in 10 of those aged 65 to 74 with a prior fragility fracture have been referred for dual X-ray absorptiometry (DXA) scanning.

This is despite NICE advising bisphosphonate treatment for all women over 75 with prior fragility fracture, and DXA scanning for all women aged 65 to 74 with prior fragility fracture.

In addition, fewer than 2 per cent of the 14,651 men aged over 65 with prior fragility fracture were referred for DXA. Of these, only 44 per cent were receiving treatment.

The figures are from the QRESEARCH database which includes data on over 3 million patients from 487 GP practices across the UK.

Lead researcher Dr Jonathan Bayly, from the University of Derby, who presented the data at the European Symposium on Calcified Tissues in Barcelona this week, said: 'Only one out of every four identifiable over 75-year-olds with prior fracture are being treated according to the NICE guideline. And this is only including the patients we can identify. The real figure is probably more like one in eight.'

Failure to add quality indicators for osteoporosis to the quality framework was a missed opportunity, he said.

'GPs need incentives to pick up missed incident fractures and find prevalent fractures. Including osteoporosis in the quality framework would have achieved that.'

Osteoporosis was tipped for inclusion in the 2008/9 framework. Instead, the DoH has made it one of five clinical directed enhanced services (DESs), funded by a share of £50 million.

Professor David Reid, chair of the National Osteoporosis Society medical board, said: 'Including osteoporosis into the framework would have improved the levels of care by making it a priority for PCTs and GPs.

'But having a DES for osteoporosis in England is a very positive move,' he added.

GPletters@haymarket.com

European Symposium on Calcified Tissues

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