New medical research published today in Current Medical Research and Opinion shows that more than half of women over the age of 65 in Coatbridge (Lanarkshire), who were identified as being at risk of osteoporosis, have or are developing the condition. This is likely to be indicative of a nationwide situation.
The research was led by Dr Eamonn Brankin of Church Street Practice, Coatbridge, Caroline Mitchell, osteoporosis nurse, and Dr Robin Munro, consultant rheumatologist, Wishaw General Hospital. It was carried out at Scotland’s first mobile scanning service located at Coathill Hospital in Lanarkshire last summer. A questionnaire was sent to all women 65 years or over living in Coatbridge and the results identified 852 women over the age of 50 years who had already had a fracture, and a further 1,434 who were at high risk of this debilitating condition.1
Nearly half of these women (1,054) were scanned using Coatbridge’s mobile DEXA scanner. Of those who had suffered a previous fracture, 51.9% were diagnosed as having osteoporosis and 34.5% were diagnosed as osteopenic, a condition many suffer as a precursor to osteoporosis.1 Patients who sustain an osteoporotic-related fracture are the highest risk group for sustaining further osteoporotic fractures.
Of those who had not broken a bone previously but had been identified as being at risk due to other factors, eight in ten had osteopenia or osteoporosis.1 None of these women knew that they had the condition.
Osteoporosis affects 200,000 women in Scotland (equivalent to one in three women over the age of 50). Key risk factors include prior fracture, diet lacking in calcium-rich foods, lack of weight bearing exercise, high alcohol consumption, smoking and early menopause.1
Dr Eamonn Brankin commented: “These results confirm that there is a large number of women who have osteoporosis but don’t know it and those at risk should seek advice from their primary healthcare team so they can be assessed and treated appropriately.”
Osteoporosis is a devastating condition and often there are no signs or symptoms until a break occurs. Although the condition itself is not life-threatening, the after-effects of fractures can be. International research has shown that, one year after a hip fracture, one in five patients died ; in Lanarkshire this is up to 30% . Other research shows that one year after a hip fracture, 40% were unable to walk unaided , 60% had difficulty with at least one essential activity of daily living6 and 80% were restricted in other activities such as driving and grocery shopping6.Treating osteoporosis makes sense for both patients and the NHS. After suffering a vertebral fracture, a patient will on average make 14 more visits to her GP in a given year.
Osteoporosis costs the NHS an estimated £1.7 billion per year or £5 million per day for hip fractures alone. These costs are likely to mount in future years because we are living longer, and osteoporosis is largely an age-related disease.
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Interviews available
· Dr Eamonn Brankin
· Patients who were scanned at Coatbridge and discovered they had osteoporosis
Notes to editors
· Osteoporosis affects around 200,000 women and 40,000 men in Scotland.3
·
In Scotland, there are 20,000 osteoporotic fractures per year.3
· Lanarkshire patients suffer 500-600 hip fractures annually.5
· Each hip fracture costs the NHS £20,000-25,000 in the first year including hospital and community care costs.5
· More than 20% of orthopaedic day beds are taken up by patients who have suffered hip fractures.3
· Half of those individuals previously able to care for themselves will become dependent post-hip fracture.5
· The Primary Care Audit in Coatbridge was carried out in June 2003 by NHS Lanarkshire. All women over the age of 64 living at home were sent questionnaires regarding osteoporosis. Responses were received from 2,386 women (59%).1
This work was supported by unrestricted educational grants from Strakan and Merck Sharp & Dohme Limited (MSD) and sponsorship from Merck Sharp & Dohme Limited, Aventis and Eli Lilly.
Further information is available from Nicky Chapple on 020 8948 8388 or 07973 288819 (mobile) or Calvin Brown on 01698 245006 or 07711 497611 (mobile).
References:
1. Eamonn Brankin, Caroline Mitchell and Robin Munro on behalf of Lanarkshire Osteoporosis Service. Closing the osteoporosis management gap in primary care: a secondary prevention of fracture programme Curr Med Res Opin. 2005; 21(4): 475-482; doi 10.1185/030079905X38150. Published online 11 March 2005: url: http://www.catchword.com/ini=libra_cmro/rpsv/cw/libra/03007995/previews/2933
2. The Care of Fragility Fracture Patients, British Orthopaedic Association, September 2003
3. Scottish Intercollegiate Guidelines (SIGN) Management of Osteoporosis Guideline No.71; Section 1, Introduction.
4. National Institute of Health. Osteoporosis prevention, diagnosis and therapy. JAMA 2001, 285 (6): 785-95.
5. Falls and fractures redesign report. NHS Lanarkshire, March 2004.
6. Cooper C. The crippling consequences of vertebral fractures. AM J Med 1997; 103 (2A): 304-435.
7. Dolan P, Torgensen DJ, The cost of treating osteoporotic fractures in the United Kingdom female population. Osteoporosis Int. 1998;8:611-6
8. Torgensen DJ,et al. The Economics of Fracture Prevention. Barlow DH ed. The Effective Management of Osteoporosis. London, Aesculapius Medical Press 2001; 111-21.
