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Gold, incentives and meh

GPs undertreat fractures

GPs are continuing to underprescribe appropriate medication for patients who have had vertebral fractures, new research suggests.

Over a third of women with fractures were not prescribed treatment such as bisphosphonates in the month after diagnosis, a study published in Annals of Rheumatic Disease (July) revealed.

The study found prescribing for fractures was rising, but even so, only 61.2 per cent of patients received treatment.

Using the General Practice Research Database, the resear-chers looked at 2,719 women over the age of 50 with a fracture diagnosed between 1990 and 2001.

Women were most commonly prescribed etidronate, followed by calcium with vitamin D. Only a few were prescribed the selective-oestrogen modulator raloxifene.

Dr Steve Longworth, past-president of the primary care rheumatology society and a GP in Leicester, said: 'This is interesting, it backs up what we already know – that osteoporosis is significantly undertreated. We're getting better at it, but we are eagerly awaiting guidance from the National Institute for Clinical Excellence.'

He said the cost of new treatments such as teriparatide (Forsteo) was 'frightening' NICE, but the prescription costs had to be weighed against the cost of treating fractures and their knock-on morbidity.

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