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GRASP-OsteoporosisRx: reducing fragility fractures

Osteoporosis is a health condition that weakens bones, making them fragile and more likely to break. One in two women and one in five men over the age of 50 will suffer a fragility fracture due to osteoporosis.

Osteoporosis and fragility fractures can have a profound impact on patients and their quality of life. Optimising medication is critical to preventing fragility fractures which can cause substantial pain and severe disability. Treatment is exceptionally effective at improving bone density – when taken correctly it can reduce the risk of fracture by more than 50%. However, evidence shows that medication adherence can be poor with around half of all patients discontinuing their medication within the first year.

The GRASP-OsteoporosisRx project (previously known as the Bone Health project) aims to reduce fragility fractures and improve the management of people with osteoporosis by identifying patients in primary care who would benefit from a medication review and ensuring they are treated appropriately. A new case-finding tool and review template has been created to easily identify appropriate patients on GP practice systems and support clinicians in carrying out reviews.

A pilot was run in eight GP practices across Oxfordshire in 2022/23. This resulted in significant improvements in coding for both osteoporosis diagnosis and QOF fragility fractures. It also led to more patients on osteoporosis medication, reducing their risk of fragility fractures. At the end of the pilot an additional 252 patients were on treatment. This equates to 13 fewer fractures within the next two years and a hospital cost saving of more than £97,000.

The GRASP-OsteoporosisRx project is a collaboration between the University of Oxford, PRIMIS (part of the School of Medicine, University of Nottingham) and Health Innovation Oxford & Thames Valley. It received funding from Health Education England.