Using WHO-FRAX to Describe Fracture Risk: Experience in Primary Care

Ideally those at highest risk of fracture should be identified prior to fracture occurrence to reduce mortality, morbidity and costs. Case-finding strategies for those at high risk of first fracture or systematic case-finding strategies following fracture are recommended in the UK, rather than popul...

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Bibliographic Details
Published in:Scottish medical journal 2012-02, Vol.57 (1), p.8-13
Main Authors: Maclean, F R, Thomson, S A, Gallacher, S J
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
Aged
Algorithms
Bone Density Conservation Agents - therapeutic use
Cost-Benefit Analysis
Cross-Sectional Studies
Decision Support Techniques
Feasibility Studies
Female
Hip Fractures - economics
Hip Fractures - epidemiology
Hip Fractures - prevention & control
Humans
Osteoporosis - drug therapy
Osteoporosis - economics
Osteoporosis - epidemiology
Primary Health Care
Risk Assessment - methods
United Kingdom - epidemiology
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Summary:Ideally those at highest risk of fracture should be identified prior to fracture occurrence to reduce mortality, morbidity and costs. Case-finding strategies for those at high risk of first fracture or systematic case-finding strategies following fracture are recommended in the UK, rather than population-based screening to identify individuals at high fracture risk. General practices in the UK hold relevant data on individuals beyond fracture history that could allow identification of a wider group of patients at highest risk of fracture. The aim of the paper is to evaluate the feasibility of applying the WHO-FRAX fracture risk calculator to general practice populations using existing recorded data. A cross-sectional study of 2467 women aged 50 years and older (mean 66.2 years, standard deviation = 11.3) registered with two Scottish General Practices with low deprivation (one semi-rural, one urban) was undertaken. Patient data were extracted from the two general practices’ patient information databases and the WHO-FRAX calculator was applied to these data. WHO-FRAX calculation was possible on 1872 patients. Of these, 687 patients were found to have a high fracture risk (risk of major facture ≥15% and or risk of hip fracture ≥3% – 37% of the WHO-FRAX assessed cohort) and should be considered for follow-up. In conclusion, use of the WHO-FRAX calculator using general practice-held data is feasible and can help to identify a patient group at higher fracture risk. Further evaluation and treatments can then be targeted at this group.
ISSN:0036-9330
2045-6441
DOI:10.1258/smj.2011.011185