title: Using WHO-FRAX to describe fracture risk: experience in primary care.
abstract: 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.
authors.affiliation: Levenside Medical Practice, Station Road, Dumbarton G82 1PW, Scotland, UK. fergus.maclean@nhs.net
authors.forename: F R
authors.initials: FR
authors.lastname: MacLean
authors.forename: S A
authors.initials: SA
authors.lastname: Thomson
authors.forename: S J
authors.initials: SJ
authors.lastname: Gallacher
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000465:Algorithms; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005240:Feasibility Studies; D005260:Female; D006620:Hip Fractures / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D011320:Primary Health Care; D018570:Risk Assessment / Q000379:methods*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D050071:Bone Density Conservation Agents