The first national evaluation of standards of care for osteoporosis and falls in primary care suggests that adding an appropriate set of codes for the condition into the Quality and Outcomes Framework could help better care.

The combined costs of social and hospital care for patients with osteoporotic fractures has been reported as more than £1.8 billion per year in the UK, the report says, and these are most likely to occur in elderly patients with osteoporosis suffering a fall. Furthermore, fractures in over 60 year olds involve more than two million bed days in England alone, and another two million are taken up by frailty related falls in patients over the age of 75, highlighting the need for a better handle on the illness.

But the survey, conducted by The Information Centre using the QRESEARCH database, which collects anonymous EMRs from patients in 525 UK general practices, revealed a mixed picture of current achievements in care. For example, it found that almost three-quarters of older women diagnosed with osteoporosis and a previous fragility fracture were being prescribed appropriate medication. But, on the down side, only one in ten with a previous fragility fracture was found to have a bone density assessment in her electronic medical record, and this figure was even lower in men, at one in 50.

Recording data

The reports suggests that low levels of achievement are partly due to practices not entering assessments or referrals that have been carried out on a patient’s EMR, and that giving osteoporosis its own slot in the QOF – an annual, performance-based reward and incentive scheme for GPs introduced in 2004 and currently under review – could boost both the provision of care and recording of relevant information.

“Work in other clinical areas such as coronary heart disease, asthma and diabetes has shown that both the quality of data recording and the level of care for these conditions can be greatly improved by incorporation in the QOF,” it concludes.