Protection against fractures is important. One in three adult women will suffer a fracture due to osteoporosis in their lifetime2 and once a patient experiences a spinal fracture they are three times more likely to experience another.3 Fractures can have a significant impact on quality of life, causing physical deformity, loss of independence and even death, while also contributing to huge healthcare costs.4,5,6
Of the GPs surveyed, 72% believed that inclusion of osteoporosis on the Quality and Outcomes Framework (QOF) would lead to improvements in osteoporosis services in the UK.1 In addition, over half believed that including quality indicators for adherence to treatment and prevention of osteoporotic fractures would lead to improved patient outcomes. 1 Up to half of patients prescribed a weekly osteoporosis treatment stop taking it within the first year, risking painful and debilitating fractures, so identifying and supporting these patients is crucial.7,8
Dr Alun Cooper, GPwSI (GP with a Special Interest in osteoporosis) and member of the Real Facts of Life Panel, a multidisciplinary group of experts with an interest in osteoporosis says, “There are around three million people in the UK who have or are at high risk of osteoporosis but are receiving sub-optimal care, despite national guidance on prevention. A systematic, incentive driven approach through inclusion of osteoporosis on the QOF is the only way to improve the diagnosis and treatment of our patients who are at risk of fragility fractures.”
The QOF was launched in 2004, as a way of rewarding GPs who deliver against a range of quality indicators that measure the quality of care they provide across a range of disease areas. Nearly all the GPs surveyed (87%) felt that they focus more on health priorities included on QOF because of the associated financial benefits. 1
In addition a new leaflet for patients with osteoporosis, BREAKfree from fractures, was launched earlier this year by the Real Facts of Life Panel. The leaflet is designed to help GPs support patients in the day-to-day management of their condition by motivating them to look after their bones and incorporating tips on maintaining healthy bones and reinforcing the importance of taking treatment as prescribed. It also includes a check-list that patients can use in conjunction with their GP to help them identify why they may be having difficulty staying on their treatment.
GPs can request copies of the BREAKfree from fractures leaflet through firstname.lastname@example.org
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NOTES TO EDITORS
About the Real Facts of Life Panel
The Real Facts of Life Panel is a multi-disciplinary group of healthcare professionals working to improve the current management of osteoporosis in the UK. The Panel’s first undertaking was the publication of the Real Life: The Real Facts of Life in Osteoporosis report in November 2004, followed by the Real Life: Cracks in Osteoporosis Care in June 2006. The Real Facts of Life Panel is supported by Roche Products Ltd. and GlaxoSmithKline (GSK).
Members of the Real Facts of Life Panel 2007
• Dr Pam Brown – GP, Grove Medical Centre, Swansea
• Peter Cattee – managing director, Peak Pharmacy Group, Derbyshire
• Dr Alun Cooper – GPwSI in osteoporosis, Bridge Medical Centre, West Sussex
• Dr Michael W J Davie – consultant physician and director of research, Robert Jones and Agnes Hunt Hospital, Shropshire
• Dr Louise Dolan – consultant rheumatologist, Queen Elizabeth Hospital, London
• Chris Martin – community pharmacist, Pembrokeshire
• Maggie Partridge – administrator and political co-ordinator for the International Society for Fracture Repair
• Prof. Hamish Simpson – professor of orthopaedics and trauma, University of Edinburgh
• Debbie Stone – specialist osteoporosis nurse, Bronglais General Hospital, Ceredigion
• Dr Peter Stott – GP, Tadworth Medical Centre, Surrey
• Sister Anne Sutcliffe – specialist osteoporosis nurse, Freeman Hospital, Newcastle upon Tyne
• Dr Nuttan Tanna – consultant pharmacist for menopause and osteoporosis, Northwick Park Menopause Clinical and Research Unit, London
About the survey
The Real Facts of Life Panel, sponsored by Roche Products Ltd. and GlaxoSmithKline (GSK), commissioned an independent market research agency to carry out an internet survey among 85 GPs (between the 10th -11th September 2007) to ascertain their expert opinion on the current management of osteoporosis in the UK.
The World Health Organisation defines osteoporosis as ‘a disease characterised by low bone mass and micro-architectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk’9
An estimated three million people in the UK suffer from osteoporosis.10 Approximately 14,000 people in the UK die each year following a hip fracture11 compared with 12,300 women who die every year from breast cancer.12
About the Quality and Outcomes Framework (QOF)
The QOF measures and financially rewards GP practices for delivering a wide range of services. GP practices score points according to their levels of achievement against these indicators, and from this payments to their practices are calculated. The QOF currently addresses 19 distinct disease/therapy areas on which all GPs must deliver.
The QOF has been undated a number of times since it was launched in 2004, most recently in April 2006. The current quality indicators and a guide to implementing these can be accessed at www.primarycarecontracting.nhs.uk/uploads/ngms/revisions_gms_contract_270306.pdf. Further updates to the QOF are thought likely to happen in early 2008, and it is expected that this will include additional indicators against which GPs will be asked to deliver
About the Roche/GSK collaboration
In December 2001, Roche and GSK announced that they would co-develop and co-promote ibandronic acid for the treatment of post-menopausal osteoporosis in all countries, except Japan. The Roche/GSK collaboration provides expertise and commitment to make new osteoporosis therapies available as quickly as possible.
About Roche in the UK
Roche aims to improve people's health and quality of life with innovative products and services for the early detection, prevention, diagnosis and treatment of disease. Part of one of the world’s leading healthcare groups, Roche in the UK employs nearly 2,000 people in pharmaceuticals and diagnostics. Globally Roche is the leader in diagnostics, and a major supplier of medicines for the treatment of cancer, transplantation, virology, bone and rheumatology, obesity and renal anaemia. Find out more at www.rocheuk.com
GSK, one of the world's leading research-based pharmaceutical and healthcare companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer.
1. Quality and Outcomes Framework (QOF) Survey. TNS Healthcare. September 2007. Sponsored by Roche Products Ltd. and GlaxoSmithKline (GSK).
2. Chami G et al. Are osteoporotic fractures being adequately investigated? A questionnaire of GP & orthopaedic surgeons. BMC Family Practice. 2006. 7:7.
3. Nevitt MC, Ross PD et al. Fracture intervention trial research group. Association of prevalent vertebral fractures, bone density, and alendronate treatment with incident vertebral fractures: Effect of number and spinal location of fractures. Bone. 1999;25(5):613-619
4. Black DM, Palermo L et al. Comparison of methods for defining prevalent vertebral deformities: the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research. 1995;10(6):890-902.
5. Keene GS, Parker MJ et al. Mortality and morbidity after hip fractures. British Medical Journal. 1993;307:1249-1250.
6. Schrager S. Osteoporosis prevention in primary care. Wisconsin Medical Journal. 2003;102(3):52-56.
7. Cramer J, Amonkar MM et al. Does dosing regimen impact persistence with bisphosphonate therapy among postmenopausal osteoporotic women? Journal of Bone and Mineral Research. 2004;19(Suppl.1):S448.
8. Ettinger MP, Gallagher R et al. Medication persistence is improved with less frequent dosing of bisphosphonates, but remains inadequate. Arthritis Rheumatism. 2004;50(Suppl.1):S513.
9. Report of World Health Organisation Study Group (1994). Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Series 843.
10. Help The Aged. Osteoporosis facts and figures [online]. Available from: www.helptheaged.org.uk [Accessed: 21st September 2007].
11. National Osteoporosis Society. Osteoporosis facts and figures V1.1 [online]. Available from: www.nos.org.uk/news/facts-and-figures.htm [Accessed: September 2007].
12. No More Breast Cancer. Facts about breast cancer [online]. Available from: www.nomorebreastcancer.org.uk
[Accessed: September 2007].
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