Using WHO-FRAX to describe fracture risk: experience in primary care

Scott Med J. 2012 Feb;57(1):8-13. doi: 10.1258/smj.2011.011185. Epub 2011 Dec 16.

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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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

Substances

  • Bone Density Conservation Agents