GPs back wider osteoporosis screening in primary care

Expansion of osteoporosis screening in primary care and a national database of fracture liaison services would improve GPs' ability to manage the condition, experts say.

Osteoporosis: GPs want better access to screening services (photo: Science Photo Library)
Osteoporosis: GPs want better access to screening services (photo: Science Photo Library)

Fracture liaison services allow for assessment and treatment for osteoporosis and falls in a single, combined service, which can be provided by GPs.

As part of the service, whenever a patient over 50 receives a ‘fragility fracture’ – when a bone is damaged disproportionately to the force of impact – they are assessed for the possibility of osteoporosis.

The service model has garnered support from many relevant professional organisations, including the Osteoporosis Society and the DH, for reducing fractures, cutting costs and improving care.

Dr Louise Warburton, GPSI and president of the Primary Care Rheumatology Society, said the database would make GP's management of patients with fractures easier.

'Current fracture liaison services are a bit hit and miss,' she said. 'This national database would enable us to audit and compare services from one area to another. Currently, most fracture liaison services are run from local hospitals, and GPs don't get much feedback from them.'

She added: 'A service run from primary care would make it easier to access the service as a GP.'

Professor David Marsh, clinical Lead for fracture liaison services, said: ‘Following the success of the National Hip Fracture Database (NHFD), we are hoping to build on this by extending the help provided to patients when they have broken a bone.’

The NHFD was established in 2007 to improve the cost effectiveness and care quality of hip fracture care. It is currently managed by the RCP.

‘If a patient breaks a bone through a slip or a fall they should be offered screening for osteoporosis. If they have osteoporosis they should then be offered bone protection medicine. If the fracture was caused by a fall the causes of the fall should be investigated and steps taken to reduce the risk of falling again. By taking these steps of screening, bone protection medicine and investigation to help reduce the risk of falls the chances of breaking another bone can be reduced,’ he added.

The RCP said they were working with a range of other service providers to explore ‘what a national database of fracture liaison services might look like’.

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