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Better NHS service provision 'could help prevent secondary fractures'

Published on 14 January 2016
Better NHS service provision 'could help prevent secondary fractures'

Improvements to current health service provisions in the UK could help hip fracture patients to minimise their risk of secondary fractures more effectively.

This is according to a new study led by the University of Oxford and University of Southampton, which aimed to identify healthcare professionals' views on effective care for the prevention of secondary fracture after an initial hip injury.

Currently, there is a substantial amount of variation in terms of how NHS services to prevent secondary fractures are delivered, with little consensus on the best models of care. This means that many people who have broken hips remain at high risk of subsequent osteoporotic fractures.

For this new research, published in the medical journal Osteoporosis International, 43 interviews were undertaken with healthcare professionals involved in delivering fracture prevention services across 11 hospitals in one English region. The staff's views on case finding, osteoporosis assessment, treatment initiation, and monitoring and coordination were analysed.

It was shown that there was no consensus on who should conduct the osteoporosis assessments, with the location and availability of the necessary dual-energy X-ray absorptiometry scanners influencing the likelihood of patients receiving a scan.

Meanwhile, it was agreed that treatment ought to be initiated in an inpatient setting rather than during the post-discharge or outpatient periods, while adherence was seen as a major concern, with respondents feeling more monitoring could be conducted by secondary care.

Additionally, participants advocated using dedicated coordinators and a combination of formal and informal methods of communication, with a gap between primary and secondary care identified as a key barrier at present.

The researchers concluded: "A number of ways of organising effective fracture prevention services after hip fracture were identified. It is hoped that this will help professionals identify gaps in care and provide information on how to develop services."

Dr Katherine Free, our research liaison and communications manager, said: "Breaking a bone can have a considerable impact on an individual's quality of life, especially in the case of older adults. As we get older, our bones begin to lose density, making them more fragile and therefore more likely to break. People affected by osteoporosis are particularly likely to be affected by subsequent fractures. However, there are interventions that can help, and early diagnosis of osteoporosis is important as lifestyle changes and drug treatments such as bisphosphonates can significantly reduce the risk of future fractures.

"Osteoporosis is a debilitating and painful condition and we are committed to finding a cure for this through our research."

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