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GPs could target women at high risk of osteoporosis for screening using three main risk factors, a new GP study concludes.

The researchers found the three most important risk factors for osteoporosis in those currently unidentified were age, a previous fracture and a stooped posture.

Screening women using just one of the risk factors could cut the numbers of those in this age group requiring a bone scan by 58 per cent, the study said.

Osteoporosis specialists said the risk factor approach would be particularly useful for GPs who had severe delays in accessing DEXA scans, otherwise patients would be left without treatment.

The research emerged as an editorial in the BMJ called on GPs to 'lobby vociferously' for improvements in falls and osteoporosis services. It argued there was still a lack of comprehensive, integrated services leading to long waits for diagnosis.

The study of 4,646 women aged 60 to 80 from 14 practices found those with a history of fracture were 60 per cent more likely to have an increased risk of osteoporosis. If they walked with a stoop they had a 50 per cent higher chance of getting the condition.

Increasing age was also significant. Women aged 75 to 80 were almost three times more likely to be at higher risk of osteoporosis than those aged 60 to 64.

The results, which appeared in the latest issue of Maturitas (July), were confirmed using PIXI scanning (peripheral instantaneous X-ray imager) ­ a cheaper alternative to gold standard DEXA scanning.

The study said that conventional risk factors of family history and steroid use were not associated with a low bone mineral density.

But study co-author Dr Jonathan Barnardo, a GP in Guildford, Surrey, said this could be a 'chance' finding due to the low numbers of patients identified as having taken a recent course of steroids.

Dr Barnado added that screening women using either a history of a prior fracture or stooped posture would reduce 'by half' the number of women that required a bone scan.

He said: 'We don't want to treat people just on risk factors alone but if you have not got access to a DEXA scan, this is a simple tool which is

second best to DEXA but better than nothing.'

Dr Pam Brown, a member of the primary care forum of the National Osteoporosis Society and a GP in Swansea, said National Osteoporosis Society guidance indicated that patients should always be referred for an axial DEXA scan to 'more accurately quantify their risk'.

Patients at increased

risk of osteoporosis

Risk factor Odds ratio

Age (over 75) 2.9

Previous fracture 1.6

Stooped posture 1.5

By Nerys Hairon

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