Evidence map›Paper›PMID 32080756›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020

Introducing mobile fracture prevention services with DXA in Northern Scotland: a comparative study of three rural communities.

R J Hollick, L McKee, J Shim, N Ramsay, S Gerring, D M Reid, A J Black

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

R J HollickAberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK. rhollick@abdn.ac.uk.ORCID http://orcid.org/0000-0001-6558-7189
L McKeeHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
J ShimAberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK.
N RamsayDepartment of Rheumatology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK.
S GerringDepartment of Rheumatology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK.
D M ReidSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
A J BlackDepartment of Rheumatology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Mobile fracture prevention services, with DXA, significantly improved access to care for those at high risk of fracture living in rural areas. Introduction of mobile services facilitated access to fracture liaison services and development of integrated of care pathways across community- and secondary-based care.

introductionThe ageing population is growing faster in rural areas, yet most fracture prevention services are located in urban areas. As part of a wider study, evaluating the introduction of mobile fracture prevention services, we focus on whether mobile services improve access to care for those at highest risk of fracture.

methodsServices outcomes were assessed against the Royal Osteoporosis Society clinical standards for fracture liaison services. This included standardised, age-specific referral rates, FRAX 10-year probability of major osteoporotic and hip fracture of referrals, pre- and post-introduction of the mobile service across two island and one rural mainland sites. This was compared with referrals from a similar rural mainland region with local access to a comprehensive service.

resultsGreatest impact occurred in areas with most limited service provision at baseline. Mean age of patients referred increased from 59 to 68 years (CI 6.8-10.1, p < 0.001). Referral rates increased from 2.8 to 5.4 per 1000 population between 2011 and 2018, with a 5-fold rise in those ≥ 75 years (0.4 to 2.0 per 1000). Mean FRAX 10-year risk of major osteoporotic fracture increased from 12.7 to 17.7% (CI 3.2-5.7, p < 0.001). Mean hip fracture risk probability increased from 3.0 to 5.7% (CI 2.0-3.4, p < 0.001). However, referral rates from the mobile sites remained lower than the comparator site.

conclusionsMobile fracture prevention services, including DXA, greatly improved uptake amongst high-risk individuals. Mobile services facilitated development of integrated of care pathways, including fracture liaison services, across community- and secondary-based care.

Indexed as

Hip FracturesOsteoporosisOsteoporotic FracturesAgedHumansMiddle AgedRural PopulationScotlandSecondary PreventionDXA scanningFracture liaison servicesGeographical accessMobile servicesOsteoporosis

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