BACKGROUND:Osteoporotic fractures have a detrimental impact on health and quality of life, are more common in older women and are costly to treat. Screening to identify older women at high risk of fracture has the potential to offer substantial benefits. Understanding women's and professionals' experiences of screening will inform the implementation of screening in routine care. OBJECTIVE: To explore the views of older women and GPs about the acceptability of screening to prevent fractures. METHODS: A qualitative study conducted within a multi-centre randomized controlled trial of the effectiveness and cost-effectiveness of screening women aged 70-85 years for the prevention of fractures; 30 women randomized to the trial screening group and 15 GPs were recruited from general practices in North Somerset and Norfolk, UK. All 30 women and 11 of the GPs participated in face-to-face semi-structured interviews. Four GPs participated in a focus group. Data were analysed thematically, using the Framework Approach. RESULTS: Women and GPs viewed screening positively, recognizing its potential to improve fracture prevention and future health. Attending screening was not found to result in anxiety or excessive activity restriction. Demonstrating cost-effectiveness was key to the acceptability of screening amongst GPs. Implementing similar screening in routine care would require consideration of access to bone density scans, information provision to participants and mode of administration. CONCLUSIONS: Our findings suggest an effective and cost-effective screening programme to reduce osteoporotic fractures could be implemented in routine care and would be well received by women and GPs.
RCT Entities:
BACKGROUND:Osteoporotic fractures have a detrimental impact on health and quality of life, are more common in older women and are costly to treat. Screening to identify older women at high risk of fracture has the potential to offer substantial benefits. Understanding women's and professionals' experiences of screening will inform the implementation of screening in routine care. OBJECTIVE: To explore the views of older women and GPs about the acceptability of screening to prevent fractures. METHODS: A qualitative study conducted within a multi-centre randomized controlled trial of the effectiveness and cost-effectiveness of screening women aged 70-85 years for the prevention of fractures; 30 women randomized to the trial screening group and 15 GPs were recruited from general practices in North Somerset and Norfolk, UK. All 30 women and 11 of the GPs participated in face-to-face semi-structured interviews. Four GPs participated in a focus group. Data were analysed thematically, using the Framework Approach. RESULTS:Women and GPs viewed screening positively, recognizing its potential to improve fracture prevention and future health. Attending screening was not found to result in anxiety or excessive activity restriction. Demonstrating cost-effectiveness was key to the acceptability of screening amongst GPs. Implementing similar screening in routine care would require consideration of access to bone density scans, information provision to participants and mode of administration. CONCLUSIONS: Our findings suggest an effective and cost-effective screening programme to reduce osteoporotic fractures could be implemented in routine care and would be well received by women and GPs.
Authors: C M Parsons; N Harvey; L Shepstone; J A Kanis; E Lenaghan; S Clarke; R Fordham; N Gittoes; I Harvey; R Holland; N M Redmond; A Howe; T Marshall; T J Peters; D Torgerson; T W O'Neill; E McCloskey; C Cooper Journal: Osteoporos Int Date: 2019-10-12 Impact factor: 4.507
Authors: Aaron T Seaman; Melissa Steffen; Taisha Doo; Heather S Healy; Samantha L Solimeo Journal: J Gen Intern Med Date: 2018-07-27 Impact factor: 5.128
Authors: P Chotiyarnwong; E V McCloskey; N C Harvey; M Lorentzon; D Prieto-Alhambra; B Abrahamsen; J D Adachi; F Borgström; O Bruyere; J J Carey; P Clark; C Cooper; E M Curtis; E Dennison; M Diaz-Curiel; H P Dimai; D Grigorie; M Hiligsmann; P Khashayar; E M Lewiecki; P Lips; R S Lorenc; S Ortolani; A Papaioannou; S Silverman; M Sosa; P Szulc; K A Ward; N Yoshimura; J A Kanis Journal: Arch Osteoporos Date: 2022-06-28 Impact factor: 2.879
Authors: Nicholas R Fuggle; Elizabeth M Curtis; Kate A Ward; Nicholas C Harvey; Elaine M Dennison; Cyrus Cooper Journal: Nat Rev Endocrinol Date: 2019-09 Impact factor: 43.330
Authors: Eugene McCloskey; Helena Johansson; Nicholas C Harvey; Lee Shepstone; Elizabeth Lenaghan; Ric Fordham; Ian Harvey; Amanda Howe; Cyrus Cooper; Shane Clarke; Neil Gittoes; Alison Heawood; Richard Holland; Tarnya Marshall; Terence W O'Neill; Tim J Peters; Niamh Redmond; David Torgerson; John A Kanis Journal: J Bone Miner Res Date: 2018-03-23 Impact factor: 6.741