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GPs reject Welsh BMA

Secondary prevention of osteoporosis is 'clearly sub-optimal' with only one in 10 women with a history of fracture receiving treatment, a new study concludes.

Researchers screened 1,054 women at risk of osteoporosis using DEXA scanning and uncovered a 'huge backlog' of patients who needed treatment but were not receiving it.

GPs and osteoporosis experts said 'much remains to be done' to identify patients at risk of osteoporosis and called for inclusion of quality points for the disease in the next draft of the framework.

The study, published online in Current Medical Research and Opinion this week, found the prevalence of osteoporosis was much higher than had been expected.

Researchers identified wo-men with fractures or osteoporosis risk factors after auditing over 2,000 women aged over 65 by postal survey, and a further 395 GP referrals. They found 86 per cent of women with a fracture history and 80 per cent with risk factors had osteoporosis or osteopenia.

Two-thirds of the screened patients were identified as eligible for treatment. Yet of the 852 women who had a fracture history, only 5 per cent had previously received a DEXA scan and 9 per cent were on drug therapies.

Research leader Dr Eamonn Brankin, a GP in Coatbridge, Lanarkshire, said the study had uncovered 'a huge backlog' of patients who had suffered fractures but not been referred for scanning because of lack of facilities.

He advised GPs to 'think fracture rather than just osteoporosis'.

He added: 'Scan those at higher risk first and remember the prevalence was higher than you thought it was.'

Dr Peter Stott, member of the National Osteoporosis Society and a GP in Tadworth, Surrey, said: 'I would be very much in favour of having osteoporosis as a quality marker along NICE guidelines which identify women as key groups.

'We could start with women with a fracture and then get the evidence for those who have not had a fracture.'

Dr Nick Summerton, a reader in public health and primary care at the University of Hull and a GP in the city, said while osteoporosis and musculoskeletal conditions were a 'major omission' from the quality framework, NICE guidelines should not just be 'transposed'.

By Nerys Hairon

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