Half the women who are at risk of bone fractures do not receive preventive treatment as recommended by the National Institute of Health and Clinical Excellence, according to pharmacists in Northumberland.
Presenting the results of their research at the British Pharmaceutical Conference in Manchester this week, the group from Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, and Sunderland University based their conclusions on data from the medical system of a 12,500 patient practice in North Tyneside. The hip fracture hospital admission rate in Northumberland is one of the highest in the UK, while there is a particularly high mortality rate after falls in North Tyneside.
NICE recommends that all at-risk women 75 years and over who have osteoporosis or a previous fragility bone fracture should receive calcium/vitamin D3 and bisphosphonate or a second line agent. Women at risk aged 74 or below should have treatment based on the results of a bone density scan (DEXA).
Of the 128 patients at risk of future fractures in the North Tyneside practice, 113 had a documented diagnosis of osteoporosis. Some 48 patients (most of whom were 75 or older) had a fragility fracture. Only 67 patients (52%) received treatment with a bisphosphonate and calcium/vitamin D3, while four patients received strontium and calcium/vitamin D3. Fourteen patients were on bisphosphonates alone. In the under-75 age group, only 24.5% had a DEXA scan.
In a further study of patient compliance with medication for osteoporosis, 52 pharmacies in Glasgow found that 70% of 353 at-risk patients were taking a bisphosphonate and calcium supplement, falling short of the 80% standard, and 77 (22%) did not take their medicines as prescribed. The most common reason for non compliance was that patients forgot to take the prescribed medicine. The Scottish pharmacists recommend that further training and support material should be provided to community pharmacists to help patient counselling on medication for osteoporosis.