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Screening for osteoporosis 'can be effective in preventing hip fractures'

Published on 11 January 2018
Screening for osteoporosis 'can be effective in preventing hip fractures'

Providing women with opportunities to attend community screening for osteoporosis could significantly reduce the number of hip fractures they suffer.

This is the conclusion of a new study led by the University of East Anglia, with funding by the Medical Research Council and Arthritis Research UK, which has suggested that screening could catch as many as one-quarter of all hip fractures before they happen.

How the screening works

The study brought together researchers from universities across the country, with a total of 12,483 women aged 70 to 85 recruited from 100 GP practices in seven regions - Birmingham, Bristol, Manchester, Norwich, Sheffield, Southampton and York.

A tool called FRAX - which predicts the probability of a hip fracture or a major osteoporotic fracture - was used to identify older women at high risk, with treatment subsequently recommended for one in seven women deemed at high risk of hip fracture.

This recommendation was acted upon by the women and their GPs, meaning that more than three-quarters of women deemed to be at high risk were receiving osteoporosis medications within six months of screening.

Although screening did not reduce the incidence of all osteoporosis-related fractures, there was strong evidence for a reduction in hip fractures, with 54 fewer women suffering one or more hip fractures compared to those receiving routine care. Among women agreeing to participate in the study, a 28 per cent reduction in hip fractures was estimated over five years.

Potential broader benefits

It is estimated that if this screening strategy was replicated nationwide among older women, the potential benefits could be widespread.

Lead researcher Professor Lee Shepstone, from the University of East Anglia's Norwich Medical School, said: "This is the first trial to show that a community-screening approach based on the FRAX fracture risk tool is both feasible and effective.

"Given that the number of costly and debilitating hip fractures are expected to increase with an ageing population, the results of this study potentially have important public health implications."

Professor Eugene McCloskey of the University of Sheffield said: "Low-cost screening with FRAX among the older population could result in effective, targeted intervention to reduce the human and socioeconomic burden of hip fractures.

"If the SCOOP screening strategy was taken up in exactly the same way as in the study in all UK women aged 70 to 85 years, we estimate that the strategy could prevent up to 8,000 hip fractures per year in the UK. Even greater gains could be made if we could reach out to women similar to those who did not take part in the study."

Arthritis Research UK's view

Dr Natalie Carter, head of research liaison and evaluation at Arthritis Research UK, said: "Tens of thousands of people a year present with hip fractures in the UK. As well as significantly increasing mortality, a hip fracture can stop a person's ability to live independently, with 43 per cent no longer being able to walk independently in the year after the fracture.

"We welcome this community-based screening programme and any other research that reduces the likelihood of fractures."

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