HIP FRACTURES could be prevented in over a quarter of cases in older women through community screening for osteoporosis, according to a research collaboration primarily between the University of East Anglia (UEA) and the University of Sheffield. SCOOP, a UK-based randomised controlled trial, showed that a low-cost screening tool called FRAX led to a 28% reduction in hip fractures over 5 years.
FRAX Screening Tool
The FRAX tool predicts the probability of a hip or major osteoporotic fracture through a simple questionnaire. In this study, it was utilised in GP practices, sometimes combined with bone mineral density measurements, in half a cohort of 12,483 women aged between 70 and 85 years. The other half received routine care.
Reduction in Hip Fractures
Of the women screened, one in seven who were deemed at high risk of hip fracture were given a treatment recommendation, which was acted upon by the patients and their GPs. Within 6 months of the screening, over three-quarters of the women shown to be at high risk were on osteoporosis medications. This led to a significant reduction in hip fractures, with 54 fewer women suffering one or more hip fractures compared with the routine care group. Not all osteoporosis-related fractures were reduced by screening.
Effective Strategy
With around 536,000 people experiencing fragility fractures, and 79,000 suffering from hip fractures each year in the UK, the utilisation of this tool could significantly reduce the human and socioeconomic impact of such ailments. The researchers estimate that up to 8,000 hip fractures per year could be prevented in the UK if the SCOOP screening strategy was taken up in all women aged 70–85 years.
Lead researcher Prof Lee Shepstone, UEA, Norwich, UK, commented: “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 have important public health implications.”
James Coker, Senior Editorial Assistant
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